Thoracentesis Also known as pleural tap, a procedure use to remove fluid from the space between the lining

of the outside of the lungs (pleura) and the wall of the chest. Fluid is collected and may be sent to a laboratory for testing (pleural fluid analysis). Diagnostic procedures:  Exudate  Transudate Risk: 
    

Bleeding Fluid buildup Infection Pneumothorax- collection of air in the space around the lungs Pulmonary edema- abnormal build up of fluid in the air sacs of the lungs Respiratory distress

How the test is performed? A small area of skin on your chest or back is washed with a sterilizing liquid. Some numbing medicine (local anesthetic) is injected in this area. A needle is placed through the skin of the chest wall into the space around the lungs, called the pleural space. Fluid is collected and may be sent to a laboratory for testing (pleural fluid analysis).

Chest Tubes and Water Seal Drainage System A chest tube (chest drain or tube thoracostomy) is a flexible plastic tube that is inserted through the side of the chest into the pleural space. 5. Air flow indicated by water bubbling in the suction control chamber/bottle. The 2nd bottle serves as the water seal container.Provides a water seal and prevents air from entering the pleural cavity. serves as the collection container for fluid. fill suction control chamber/bottle to the ordered level of fluid. Level of suction determined by air flow through the water in the suction chamber/bottle. If suction ordered. which is directly attached to a patient. a water-seal chamber and a suction chamber PROCEDURE: 1.  Two-bottle system. as in the one-bottle system. 4.Water seal and collection of drainage occurs in the same bottle. or pus (empyema) from the intrathoracic space. chyle).F 20-24  Fluid. Underfilling leaves water seal chamber/bottle tube exposed to air. Set up the system at the child¶s bedside keeping drainage system below the level of the child.  Three-bottle system. The 2 cm level is sufficient to create a one-way valve to prevent air from entering the pleural cavity through the chest tube. Prevents back flow of fluid or air into the pleural cavity . Chest tubes are used after chest surgery and chest trauma and for pnuemothorax or hemothorax to promote lung re-expansion. If only water seal ordered. Turn on suction. It is used to remove air (pneumothorax) or fluid (pleural effusion. A chest tube is inserted and a closed chest drainage system is attached to promote drainage of air and fluid. Provides suction to the system.Water seal and collection of drainage are in separate bottles. blood. 3.F28 or F32 for larger tubes Chest Drainage Principles:  Gravity  Positive Pressure  Suction  Water-seal principle Types of Chest Drainage:  One-bottle system. Provides extra suction to increase drainage from the pleural cavity. If suction ordered. fill the water seal chamber/bottle with sterile water or saline to the 2 cm level. attach suction tubing to the marked suction port and to the suction source. The 1st bottle.It has a collection chamber. usually 10±20 centimeters of water. Increase level of suction until there is gentle bubbling in the suction control chamber/bottle of the system. overfilling inhibits air from exiting pleural space. Used for simple pneumothorax. 2. Chest tube size:  Pure pneumothorax.

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