Chest Tubes
NUR 240 Lab
Rosemary Russell, RN, MSN
Professor of Nursing 1
, Mediastinal
Chest Tubes →
http://www.youtube.com/watch?feature=play
er_embedded&v=G8eZxqi43qQ in
http://www.youtube.com/watch?feature=play
er_embedded&v=4GTecWv5h6c out
2
Pleural
,Purpose
n Remove air and/or
fluid from the pleural
space
n Restore NEGATIVE
intra-pleural pressure,
so the lungs can re-
expand
Small amt of fluid /air
reabsorbed over time
3
,n Pleural space
Potential space between
visceral pleura & parietal
pleura
n Pleural fluid – 50mL
Produced by pleural cells
Separates and Lubricates
Holds 2 layers together,
- creating NEG pressure
- keeps lungs expanded 4
,Basics
n Intra-pleural pressure negative
n If intra-pleural pressure = atmospheric
(positive) → lungs collapse
Re-establish atmospheric and
intrathoracic pressure gradients
5
, Air – Blood – Fluid – Pus
Indications → pleural or mediastinal
n Pneumothorax
¨ Air: rib fracture; gunshot / knife wound; thoracotomy;
spontaneous pneumothorax d/t forceful coughing or
rupture of bleb; line placement; bronchoscopy
n Hemothorax
¨ Accumulation of blood in the pleural space
n Hemopneumothorax – air and blood – 2 CT’s
¨ Apex for air and base for fluid
n Open chest procedures (OPH) or blunt/penetrating
trauma
6
NUR 240 Lab
Rosemary Russell, RN, MSN
Professor of Nursing 1
, Mediastinal
Chest Tubes →
http://www.youtube.com/watch?feature=play
er_embedded&v=G8eZxqi43qQ in
http://www.youtube.com/watch?feature=play
er_embedded&v=4GTecWv5h6c out
2
Pleural
,Purpose
n Remove air and/or
fluid from the pleural
space
n Restore NEGATIVE
intra-pleural pressure,
so the lungs can re-
expand
Small amt of fluid /air
reabsorbed over time
3
,n Pleural space
Potential space between
visceral pleura & parietal
pleura
n Pleural fluid – 50mL
Produced by pleural cells
Separates and Lubricates
Holds 2 layers together,
- creating NEG pressure
- keeps lungs expanded 4
,Basics
n Intra-pleural pressure negative
n If intra-pleural pressure = atmospheric
(positive) → lungs collapse
Re-establish atmospheric and
intrathoracic pressure gradients
5
, Air – Blood – Fluid – Pus
Indications → pleural or mediastinal
n Pneumothorax
¨ Air: rib fracture; gunshot / knife wound; thoracotomy;
spontaneous pneumothorax d/t forceful coughing or
rupture of bleb; line placement; bronchoscopy
n Hemothorax
¨ Accumulation of blood in the pleural space
n Hemopneumothorax – air and blood – 2 CT’s
¨ Apex for air and base for fluid
n Open chest procedures (OPH) or blunt/penetrating
trauma
6
