The doctor would perform a chest tube drainage procedure to remove fluid from the patient's right hemothorax. A chest tube would be inserted through the thorax and connected to suction to drain fluid and air from the pleural space, preventing further fluid or air buildup and helping the lung re-expand. The nurse's responsibilities would include properly caring for and monitoring the chest tube drainage system.

1.  If a patient come in emergency department with the
complain of sever chest trauma on X-ray examination
doctor find that he is having right side hemo-thorax. What
would be the invasive intervention done by the doctor to
remove fluid….?

3. ChestDrainage System

4. • Achesttubeis a catheterinsertedthrough the
thorax to remove air and fluids from the pleural
space,to prevent air or fluid from re- entering
the pleural space,or toRe-establish normal
intrapleural and intrapulmonic pressures

5. 1. Removefluid & air aspromptlyaspossible
2. Preventdrained air & fluid from returning to
the pleuralspace
3. Restorenegative pressurein the pleural
spaceto re-expand thelung

6. 1. Expiratory pressure
2. Gravity
3. Suction

7. 1. PRE PROCEDURE
2. INTRA-PROCEDURE
3. POST PROCEDURE

8. 1. Identify the patient
2. Monitor the patient vitals
3. Explain about the procedure
4. Inform consent & procedure consent.
5. Preparation of articles and environment

9. 1. Marking the sites
2. Pre- procedure medication
3. Provide position as per procedure
4. Access IV line
5. Assist the procedure with aseptic technique
6. Monitor patient vitals in between

10. 1. Keepachesttube systemclosedandbelow the chest
2. Thetube shouldbesecuredto the chestwall.
3. Watchfor slow,steadybubbling in the suction-
control chamber andkeepit filled with sterile
water at the prescribed level.

11. 1. Monitor patient vitals and comfort
2. Replace the articles and recording & reporting
(Documentation)
3. Assess the pain by pain scale and management

12.  watch for fluctuation (tidaling) of the fluid levelto
ensurethat the chesttube is in place
 If fluctuation is less the 2 cm look for blockage
 If blockage is present milking is done
 Makesureconnectionsare tight andtaped
 Report anyunexpectedcloudy orbloody drainage.
 Assist thedressing and if any exudates is present
send for culture

13. • Check for bubbling
• Mark the level on the outside of the collection
chamberseveryshift.
• Donot let the tubing kink or loop
• Drainagebag shouldbe below the chestlevel

14. • Encourageyour patient to cough,deepbreath, and
usethe incentivespirometer.
• Advice for ROM if not contra-indicated
• Routinely accessrespiratory rate, breath sounds,
SpO2levels.
• Check for insertion site& skin inspection

15. • Clamping a chest tube is contraindicated when
ambulating or transporting a patient. Clamping can
result in aTensionPneumothorax

16. 1. Drainage less than 50-100ml of fluid per day.
2. 1-3 days post cardiac surgery.
3. 2-6 days post thoracic surgery.

17. Problem statement:-Nurses’ knowledge and
Practice regard Care of Patient with Chest
Drain.
Researcher name:-Dr. Badria A. Elfaki , Dr.
Hassanat E. Mustafa , Prof. Alaadin Hassan
Ahmed.
Aim :-The study aim to assess nurses’
knowledge and practice for patient
connected to chest drain

18.  Design:- A descriptive design.
 Sample :-50 nurses.
 Setting :- Sudan Heart Centre hospital.
 Results:-
knowledge :-All nurses were known chest drain is sterile
procedure, and more than 60.0% were known the chest drain
needs inform consent, indications and site of insertion. Although
more than 60% of them didn’t know exactly underwater-seal,
position of patient during insertion the tube, routine milking or
striping will increase pleural pressure and mobility of patient with
chest drain. Also nurses had average knowledge about the basic
principles of drain function, complications, actions when tubes
leakage, displacement or dislodge.
Practice:-poor level of practice towards preparation of
equipment for insertion the chest drains and routine patient care.

19. 1. Write nursing responsibility of a patient with ICD