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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.
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.
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 ...
The Seldinger technique is used for angiography, insertion of chest drains and central venous catheters, insertion of PEG tubes using the push technique, insertion of the leads for an artificial pacemaker or implantable cardioverter-defibrillator, and numerous other interventional medical procedures.
In traumatic pneumothorax, chest tubes are usually inserted. If mechanical ventilation is required, the risk of tension pneumothorax is greatly increased and the insertion of a chest tube is mandatory. [13] [40] Any open chest wound should be covered with an airtight seal, as it carries a high risk of leading to tension pneumothorax.
Chest tubes are usually removed one week after surgery along with any stitches or staples in the incisions. Patients experiencing shortness of breath will be guided through deep breathing or coughing exercises by a physician or respiratory therapist. In severe cases, the patient will also receive oxygen supplementation through a mask or nostril ...
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.
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]