| ID | 419 |
|---|---|
| Name | INSERTION OF CHEST TUBE |
| Cause | |
| Signs Symptoms | |
| Diagnosis | |
| Investigations | |
| Management | If a continuous drainage is required (eg. empyemas) a portex tube has to be inserted and this must be connected to a continuous suction pump. The size of catheter should be the largest size that can be inserted for the particular patient. The Argyle trocarcath is currently used. The following sizes are recommended-8 F for neonates 10 F for infants 12 F 1-2 yr. 14-16 F>2yr. Technique: 1. The skin over anesthecised area is nicked with a scalpel. 2. Holding the incision steady over the center of the interspace by stretching the skin the trocarcath is thrust into the lateral pleural cavity, taking great care to “guard” the shaft so that too deep an entry is prevented. 3. The trocar is withdrawn taking care to avoid pullinng the catheter out at the same time. Lightly clamp the catheter. 4. The catheter is directed downwards, and adjus-ted usually with about 4-10 cm of tube (depending on age of patient) inside thoracic cavity and then anchored to the skin with a purse-string suture around the tube, leaving the 2 long ends knotted together. 5. The catheter should be connected to an under-water drainage bottle and continuous suction pump and then clamp removed. Pressure of pump depends on size of patient (5-10cm H O). When should drainage tube be removed: Tube must remain in place until empyema cavity becomes obliterated. As the cavity closes the tube must be shortened appropriately. When chest tube needs to be removed, apply clamp on the tube, cut anchoring suture and, holding the purse-string suture taut, pull out the catheter quickly. Tie the purse-string suture firmly to close the opening on the chest wall. |
| Introduction | |
| History | |
| Etiology | |
| Clinical Features | |
| Preventions | |
| Treatment | |
| Complications | |
| Prognosis | |
| Types | |
| Classification | |
| Observation | |
| Pathology |
© Pakistan Drug Directory. All Rights Reserved.
Designed By: Pakistan Drug Directory Team