Under Water Seal Chest Drainage Systems

An underwater seal chest drainage system, usually referred to as a chest tube, is used to re-inflate a collapsed lung as well as remove blood and other fluids. The system is a two-chambered or three-chambered plastic unit with vertical columns with measurements marked in milliliters.

Purpose

• Chest tubes also restore proper air pressure to the lungs. Pressure around the lungs is lower than atmospheric pressure outside the body. A buildup of fluid or an open chest injury allows pressure to rise, and collapses the lung.

Insertion

• Chest tubes are commonly inserted at the bedside, and it is a sterile procedure. Insertion trays provide the needed sterile equipment. The patient is usually given a local anesthetic, such as Lidocaine injection, by the physician before inserting the tube.

Nursing Care

• The nurse is responsible for maintaining a properly functioning chest drainage system and charting the output each shift. The physician uses this information to determine when to remove the chest tube.

Trouble Shooting

• A small amount of bubbling in the sterile saline chamber is normal when the tube is inserted. However, vigorous, constant bubbling indicates an air leak and the physician should be notified.

Warning

• The chest tube drainage system should sit on the floor so that it is below the level of the patient's chest. Raising the system can cause fluid to re-enter the space. The nurse should also listen to breath sounds routinely and make note of any changes, or if the patient suddenly becomes short of breath.