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Chest tubes are also provided in right angle, trocar, flared, and tapered configurations for different drainage needs. As well, some chest tubes are coated with heparin to help prevent thrombus formation, though the effect of this is disputed. [16] Chest tube have an end hole (proximal, toward the patient) and a series of side holes.
A thoracostomy is a small incision of the chest wall, [1] with maintenance of the opening for drainage. [2] It is most commonly used for the treatment of a pneumothorax.This is performed by physicians, paramedics, and nurses usually via needle thoracostomy or an incision into the chest wall with the insertion of a thoracostomy tube (chest tube) or with a hemostat and the provider's finger ...
Double lumen tubing: allows for a separation of fluid and air, sub-atmospheric pressure is measured via the thinner of the two tubes. This allows one to monitor the sub-atmospheric pressure very close to the pleural space; therefore, the system works correctly, irrespective of where it is placed.
Complications are not common but include infection, lung abscess, and bronchopleural fistula (a fistula between the pleural space and the bronchial tree). [4] A bronchopleural fistula results when there is a communication between the laceration, a bronchiole, and the pleura; it can cause air to leak into the pleural space despite the placement of a chest tube. [4]
The edges of the incision are then brought together. [1] The flap allows for 1) passive drainage of the pleural space and 2) negative pressure to develop in the thoracic cavity due to it being easier for air to escape than to enter the chest. The lung can then expand to the chest wall and seal the inner opening of the flap. [3]
A separate complication that may occur includes a misplaced intubation. Specifically, if the measured length of the NG tube is too long, the tube may coil in the stomach, causing the tip of the tube to be in the esophagus or the duodenum. On the other hand, if the tube is measured too short, the tip of the NG tube may only reach the esophagus.
Thoracostomy tubes with a diameter of 24–36 F (large-bore tubes) should be used, as these reduce the risk of blood clots obstructing the tube. Manual manipulation of chest tubes (referred to as milking, stripping, or tapping) is commonly performed to maintain an open tube, but no conclusive evidence has demonstrated that this improves ...
A tracheostomy tube may be single or dual lumen, and also cuffed or uncuffed. A dual lumen tracheostomy tube consists of an outer cannula or main shaft, an inner cannula, and an obturator. The obturator is used when inserting the tracheostomy tube to guide the placement of the outer cannula and is removed once the outer cannula is in place.