Evaluasi pemasangan WSD

1. Laceration or puncture of intrathoracic and/or abdominal organs, which can be prevented by

using the finger technique before inserting the chest tube
2. Introduction of pleural infection—for example, thoracic empyema
3. Damage to the intercostal nerve, artery, or vein:
 Converting a pneumothorax to a hemopneumothorax
 Resulting in intercostal neuritis/neuralgia
4. Incorrect tube position, extrathoracic or intrathoracic
5. Chest tube kinking, clogging, or dislodg-ing from the chest wall, or disconnection from the
underwater-seal apparatus
6. Persistent pneumothorax:
 Large primary leak
 Leak at the skin around the chest tube; suction on tube too strong
 Leaky underwater-seal apparatus
7. Subcutaneous emphysema, usually at tube site
8. Recurrence of pneumothorax upon re-moval of chest tube; seal of thoracostomy wound not
immediate
9. Lung fails to expand because of plugged bronchus; bronchoscopy required
10. Anaphylactic or allergic reaction to sur-gical preparation or anesthetic

ATLS 9TH EDITION, Page number 120

Tanda dan gejala tension pneumothorax

A tension pneumothorax develops when a “one-way valve” air leak occurs from the lung or through the
chest wall. Air is forced into the pleural space without any means of escape, eventually com-pletely
collapsing the affected lung. The mediastinum is displaced to the opposite side, decreasing venous re-
turn and compressing the opposite lung.
Shock results from the marked decrease in venous return causing a reduction in cardiac output and is
often classified as obstructive shock.

ATLS 9TH EDITION, Page number 96-97