What Are the Dangers of Chest Tubes Being Pulled Out in Patients?

Chest tubes are placed between two ribs through the intercostal space and into the pleural cavity. The tubes are used to drain fluids and/or inflate a collapsed lung. Restoring a person’s breathing is an essential life saving step in the emergency room. Chest tubes are also inserted after surgery for fluid drainage.

Risks of Chest Tubes

• Bleeding is a complication when a tube is inserted. If the blood accumulates around the lung, it can require surgery.

  Infection is a risk that can become very serious. Any apparatus that leads from the outside of the body into a cavity or organ can be a pathway for bacteria.

Avoid Problems

• Nursing staff can maintain a certain level of integrity by checking on a chest tube and its surroundings. Staff should keep the tube below chest level so gravity can cause fluids to drain properly. The tube should be checked for kinks and secured with tape to the chest to ensure the tube remains in place.

  Consistent monitoring of fluid drainage and the overall condition of the patient will avoid problems later.

Manipulation

• There are ways to keep a tube from blocking when filling with fluids. Manipulation of a chest tube is necessary sometimes in order to clear fluids from clogging the tube. The nurse should avoid aggressive movements of the tube and squeezing. A procedure that calls for a hand-over-hand that pulsates is less aggressive, and can be used to gently maneuver fluids through the tube.

  Clamping a tube should be avoided, but may be necessary when looking for a leak.

Dislodged Tube

• Gauze should be kept close to the bed at all times. In case of dislodging, the gauze is used to occlude the open site and keep air from getting into the cavity. Use precautions when handling sterile gauze with a bare hand. Peel the wrapper back and hold it from the outside, not touching the gauze with the ungloved hand.

  Call a surgeon to re-insert the tube, and monitor the patient for subcutaneous emphysema, or air that has escaped into the tissues under the skin. It is easily recognizable since it will crackle, similar to Rice Krispies. It can cause extreme swelling of the face and chest and hinder breathing.

Considerations

• Patients should be aware that even though a chest tube can be uncomfortable, it is keeping them breathing. They need to avoid sudden movements that can jerk the tube out of place. It is best not to touch the tube as bacteria can travel into the wound site.