Procedural Steps For Chest Tube Insertion

- اعداد

دليل الأقسام الداخلية

تحت اشراف

-        أ.د/ محمد لطيف   الرئيس التنفيذي للمجلس الصحي المصري     - د/ كوثر محمود نقيب عام التمريض المصري – عضو مجلس الشيوخ

اعداد

- Oath of Profession

"I swear by Almighty God that I will be loyal to my work, fear God in my profession, respect its laws and regulations, and perform my duties with efficiency and sincerity.
I will base my performance on the knowledge derived from nursing sciences, exert my utmost efforts to care for all those entrusted to me, preserve their dignity, keep their secrets, defend their rights, and protect them from harm.
I will not fear reproach when speaking the truth, and I will provide a safe environment for the patient, their family, and society.
I will continue to develop myself, show respect for those who taught me, and work with my colleagues in the profession for goodness and piety.
God is my witness to what I say."

- Vision and Mission of Nursing Care

Vision of Nursing Care in the Internal Patient Care Unit

- Definition

A chest tube is a surgical procedure in which a tube is inserted through the chest wall into the pleural cavity to drain accumulated fluid or air. This procedure is used for multiple medical conditions related to organs inside the chest, such as the lungs

- Types of Thoracotomy

1. Simple Thoracostomy:
• A drainage tube (chest tube) is inserted to drain fluid or air.
2. Diagnostic Thoracostomy:
• Used to identify the exact cause of problems in the pleural cavity, such as direct examination of accumulated fluid.

- Common Indications for Thoracotomy

1. Pneumothorax:
• Accumulation of air in the pleural cavity, leading to lung collapse.
2. Pleural Effusion:
• Fluid accumulation in the pleural cavity due to conditions like pneumonia, cancer, or heart failure.
3. Pleuritis:
• Inflammation of the pleura surrounding the lungs, causing fluid accumulation or difficulty in breathing.
4. Chest Trauma:
• Chest injury that leads to blood or air accumulation in the pleural cavity.
5. Chronic Lung Diseases:
• Conditions such as pulmonary fibrosis that may require drainage of accumulated fluid.

- Nursing Role in Chest Tube Cases

1. Before the Procedure:
• Assessment and Preparation:
• Comprehensive assessment of vital signs, medical history, and respiratory exam.
• Educating the patient and their family about the procedure, its purpose, and what to expect.
• Preparing the patient, ensuring fasting if required, and prepping the area for tube insertion.
• Preparing all necessary equipment, including the chest tube and sterilization supplies.
2. During the Procedure:
• Supporting the Medical Team:
• Assisting the surgical team during the insertion of the tube and ensuring that all equipment is available.
• Monitoring the patient’s vital signs and observing the effects of anesthesia.
3. After the Procedure:
• Monitoring and Direct Care:
• Ensuring that the chest tube is functioning properly and fluids/air are draining as expected.
• Inspecting the insertion site for any signs of infection or bleeding and changing the dressing as needed.
• Pain Management:
• Assessing the patient’s pain level using pain scales and administering analgesics as prescribed.
• Helping the patient find a comfortable position and providing emotional support.
• Monitoring Vital Signs:
• Observing the patient's breathing, respiratory rate, and oxygen levels.
• Monitoring the amount of fluid or air being drained and ensuring the tube is not blocked.
4. Patient Education and Guidance:
• Teaching the patient how to care for the chest tube, especially if it needs to remain in place for an extended period.
• Providing instructions on breathing exercises or self-care.
• Planning for discharge care, including follow-up care and tube care instructions.
5. Monitoring for Complications:
• Watching for signs of complications such as infection, bleeding, or tube obstruction.

- References

• https://www.ncbi.nlm.nih.gov/books/NBK459199/

• https://www.sciencedirect.com/science/article/pii/S002013831730414X
• https://onlinelibrary.wiley.com/doi/10.1155/2012/256878