CTD(Chest Tube Drainage)

=water sealed thoracic drainage

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Purpose

Remove abnormal things-air, water, blood, inflammatory exudate-within the pleural cavity.

To re-expanding the lung to make the inside of the pleural pressure normal.

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Indication

After pleural operaition, Pneumothorax, Hemothorax, Pyothorax, Pneumohydrothorax

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Insert sites

Air removal : medial clavicle line's second intercostal

Blood or exudate removal : post axillary line's 7th~8th intercostal or 8~9th intercostal

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Organization

1. Trap bottle : Drain the air and blood in thorax

2. Under water seal bottle : Remove the air in patient's body by moving under water seal bottle's long transparent pipe through the trap bottle's short glass pipe.

3. Manometer bottle : To make negative pressure between patient's thorax and atmosphere to maintain 15cmH2O pressure between under water seal bottle and manometer bottle.

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Care&Suggestions

-The bottle is always placed 70~90cm below the patient's chest.

-Take painkiller 30minute before the treatment

-Semi-fowler's position

-After the treatment, Dressing completely(closed)

-Obser vate tidaling of water in sealed bottle.(This is normal state and this means patient's ventilation. Tube is opening and the function is good.)

-Record the amount, color, smell, density and so on. (If the amount is up to 100ml per hour, report to Dr.)

-Observate symmetrical expansion of thorax and abnormal breathing sound.

-Make patient deep breathing, coughing, shoulder exercising of the CTD site.

-Using kelly for moving(Let it besite of the patient)

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For our hospital's materials

S-set(Y-gauze, gauze), chest tube, bottle, kelly, lidocaine, 10cc syringe x2, normal saline 1l, chest binder, extension tube x2

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