Nursing procedures in operations theatre

• Sterile chest drainage bottles, fully assembled
• Sterile gloves (for the assisting nurse)
• Adhesive tape
• Sterile distilled water
• Rubber tubing

Procedure:

Single-Bottle System:

1. Fill the bottle with 5 cm of sterile distilled water. Mark the exact level on tape and place it at eye level after the system is fully set up.
2. Insert a long glass tube through one opening and a shorter tube through the other.
• The long tube must be submerged 2 cm under the water level.
3. Seal the bottle with a rubber stopper to prevent air from entering the chest cavity.
4. The shorter tube serves as an air vent, ensuring proper drainage from the lungs.
5. Ensure the vent tube is not submerged under the water.
6. Secure all tubing connections with a valve near the bottle entry point to prevent air leaks.
7. The valve remains with the patient at all times to close the system when changing bottles or moving the patient.
8. Attach adhesive tape to the bottle to record drainage levels and frequency.

Two-Bottle System:

1. Set up the system similarly to the single-bottle system, ensuring the first bottle collects drainage and the second bottle regulates suction.
2. Connect the second bottle via a tube attached to the first bottle’s rubber stopper.
3. A third opening in the second bottle is used to control suction pressure.
4. If suction is prescribed by the surgeon, attach a third tube to the second bottle and connect it to the suction source.
5. Fill the second bottle with 5 cm of sterile distilled water, ensuring the glass tube is submerged 1-2 cm under the water.
6. Secure all connections with adhesive tape.
7. Insert a rubber tube into one of the bottles.
8. Use a marked tape strip to track drainage levels over time.
9. Typical chest drainage is between 1-2 cm of fluid per hour.
10. Secure the rubber tube to the first bottle with adhesive tape.

Three-Bottle System:

1. The first bottle collects the drainage from the patient but does not contain water.
2. The second bottle acts as the water-seal chamber to prevent air from entering the chest cavity.
3. The third bottle regulates the suction pressure.
4. The third bottle must contain at least 50 cm of sterile distilled water.
5. The third bottle’s rubber stopper has three openings:
• One for air exit.
• One for suction control.
• One for connection to the second bottle.