How to Maintain Chest Tubes During the Transport of a Patient

Chest tubes are placed inside a patient who has experienced surgery, illness, trauma which caused fluid accumulation inside the chest, or lung collapse. Once a chest tube has been placed and verified to be in correct position by an X-ray, it can be stabilized for patient transport. Monitoring and maintaining a chest tube requires diligence and a working knowledge of the type of chest tube system being used and how to troubleshoot problems which may arise.

Things You'll Need

• Chest tube
• Gauze
• Tape
• Chest tube collection container
• Sterile water
• Chest tube monitoring forms

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Instructions

• 1

  Ensure that the chest tube is properly secured to the patient with either a tube harness or tape and gauze. Check each connection between the patient, tube, and collection chamber to ensure security. Check that the chest tube has adequate security to tolerate movement during transport.

• 2

  Assess the collection chamber to ensure it is in an upright position and at a lower level than the insertion site at all times during transport. Ensure that all tubing is free of kinks or occlusions at all times. Stabilize additional lengths of tubing by looping it gently and securing it to the cot or bed to prevent it from catching on anything.

• 3

  Monitor the collection chamber for rapid filling and be prepared to empty or replace the collection chamber at any time per your facilities guidelines.

• 4

  Assess the water-seal chamber for bubbling or reduced fluid. Assess the patient, chest tube, and tubing for sources of air leaks if constant bubbling is present, or if the water level reduces beyond acceptable guidelines.

• 5

  Monitor the suction chamber during transport according to your facility policy and the patient’s specific needs. Ensure that the water level in the suction port remains at an appropriate level and that the suction tubing remains open to the air and unblocked, if indicated by a physician’s orders.

• 6

  Reassess your patient during transport for changes in condition. Assess heart, lungs, respiratory status, and complete a physical exam as required by your facility. Monitor the tube insertion site to assess for bleeding or drainage around the tube or any adverse changes. Ensure dressings remain in place around the tube, and replace as needed en route.