Chest tube insertion care

1. CHEST TUBE INSERTION
•
DEFINITION
•
THE TUBE AROUND YOUR LUNG IS PLACED
BETWEEN YOUR RIBS AND INTO THE SPACE
BETWEEN THE INNER LINING AND THE OUTER
LINING OF YOUR CHEST CAVITY. THIS IS
CALLED THE PLEURAL SPACE. IT ALLOWS YOUR
LUNGS TO FULLY EXPAND
.

3. DESCRIPTION OF CHEST TUBE INSERTION
• SOMETIMES, YOU WILL RECEIVE MEDICINE
THROUGH A VEIN (INTRAVENOUS, OR IV)
TO MAKE YOU RELAXED AND SLEEPY.
• YOUR SKIN WILL BE CLEANED AT THE SITE
OF THE PLANNED INSERTION

4. •The chest tube is inserted through a 1-inch (2.5
centimeters) cut in your skin between your ribs.
Then it is guided to the correct spot.
•The tube is connected to a special canister.
Suction is often used to help it drain. Other
times, gravity alone will allow it to drain.
•A stitch (suture) and tape keep the tube in
place.

6. WHY THE PROCEDURE IS PERFORMED
•CHEST TUBES ARE USED TO TREAT
CONDITIONS THAT CAUSE A LUNG
TO COLLAPSE. SOME OF THESE
CONDITIONS ARE
•SURGERY OR TRAUMA IN THE CHEST
•AIR LEAKS FROM INSIDE THE INTO
THE CHEST (PNEUMOTHORAX(

7. •FLUID BUILDUP IN THE CHEST( CALLED A
PLEURAL EFFUSION(DUE TO BLEEDING INTO
THE CHEST, BUILDUP OF FATTY FLUID,
ABSCESS OR PUS BUILDUP IN THE LUNG OR
THE CHEST, OR HEART FAILURE

8. IMAGESCHEST TUBE INSERTION –
SERIES—AFTERCARE

10. •TYPES
• CHEST TUBES COME IN SEVERAL SIZES.
MANUFACTURERS USE A FRENCH CATHETER SCALE,
ABBREVIATED AS FR, TO CLASSIFY THE TUBES
ACCORDING TO THEIR INTERNAL DIAMETER. ONE
FR IS ONE-THIRD OF A MILLIMETER AND CHEST
TUBES ARE AVAILABLE IN SIZES RANGING FROM 6
–
40 FR.
•
• DOCTORS CAN USE STRAIGHT TUBES OR PIGTAIL
TUBES, WHICH COIL AT THE END. THEY WILL
SELECT THE SIZE OF CHEST TUBE THAT SUITS THE
INDIVIDUAL’S ANATOMY AND THE PROCEDURE.

11. •Thetip, which contains drainage holes.
•The body, which has markings that
indicate how far a doctor has inserted the
tube.
•The tail, or end, which tapers slightly for
connection to a suction or drainage
system.
Generally, chest tubes divide into two size
varieties: large-bore and small-bore.

12. Generally, chest tubes divide into two size
varieties: large-bore and small-bore.
A large-bore chest tube is 20 Fr or larger, while a
small-bore chest tube is smaller than 20 Fr.

13. Smaller tubes are also
available and are known as
pleural catheters. Doctors will
often tunnel them in a vein or
carefully place them under the
skin of the chest for long-term
use.

14. Procedure

15. A doctor may put a
person under general
anesthesia for a chest
tube insertion.
Alternatively, they will
use a local anesthetic to
numb the area before
inserting the tube and
will also provide the
person with sedation
and pain medications.

16. •Elevating the head of a
person’s bed by 30–60 degrees.
Someone will usually raise the
arm on the affected side above
the head.

17. •Identifying the tube insertion
site. This will typically be between
the fourth and fifth ribs or between
the fifth and sixth ribs, just behind
the pectoralis (chest) muscle.

18. •Using local anesthetic to numb the
insertion site. Once the area is completely
numb, a doctor may insert a needle more
deeply to see if they can pull back fluid or air.
This will confirm that they are in the right area.

19. •Making an incision of about 2–3
centimeters (cm) through the
skin. Using a surgical instrument
called a Kelly clamp, the doctor will
widen the incision and gain access
to the pleural space. The clamp
insertion should be slow to avoid
puncturing the lung.

20. •Inserting a gloved finger into
the incision site. This is to
confirm that the area is the
pleural space. The doctor will
also feel for unexpected findings,
such as a mass or scar tissue.

21. •Inserting the chest tube through
the incision site. If fluid begins to
drain through the tube, it is in the
right place. It is also possible to
attach the tube to a chamber
containing water that moves when a
person breathes. If this does not
occur, the tube may need
repositioning.

22. •Suturing the tube in place so
that the seal is as airtight as
possible.
•Covering the tube insertion site
with gauze pads.
A chest X-ray can also help to
confirm the tube’s placement.

23. Complications
During a chest tube insertion, the
doctor must work around several
major organs, including the lungs
and heart.

24. Potential complications include:
•cardiac shock, if the tube punctures
an area of the heart
•excessive bleeding
•infection

25. •injuries to the heart, blood
vessels, arteries, or lungs
•perforation (puncturing) of the
diaphragm
•punctured lung
A doctor should carefully explain
these risks to the individual before
the procedure.

26. Chest tube removal
Doctors remove chest tubes when
they are no longer necessary, for
example when the tube is no
longer draining blood or fluid.
They will also remove the tube if it
becomes blocked or is not working
correctly.

27. According to the Chest Foundation, most people
need to keep the chest tube in for a few days.
When removing a chest tube, a doctor will cut the
sutures holding the tube in place and gently pull it
out. The procedure can be uncomfortable, but
should not be painful.

28. Recovery
People should monitor the incision
site for signs of infection while it
heals, and inform their doctor as
soon as possible if the wound swells,
turns red, or starts oozing pus. It is
likely that a small scar will remain at
the insertion site.

29. Outlook
A chest tube can be a relatively
non-invasive way to access the
pleural space to drain fluid or
administer medication.
Sometimes, if the chest tube does
not resolve a person’s problem,
they may need more invasive
surgery.

30. After chest tube removal, a
person should follow a
doctor’s recommendations on
how to care for the incision
site.

31. Name; Aya Atef abd Almotalib
Number; 151
Name: Aya Muhammad Abdel
Basir Abdel Hafez
Number : 156
Name:Aya kamal Abd Elmjed
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32. Name; Aya Abdellah Fouly Abdellah
Number;153
Name. Aya Fathi Eid mohammed
Number.154
Name,: Aya Amer Ali Habbeb
Number152