Mod 13 Thoracic Drainage

Question 1

Indications for a pneumothorax?

Answer 1

• decreased breath sounds
• midline deviation
• tachypneic (fast breathing) or fast HR
• distant muffled cardiac sounds

Question 2

Game plan/Therapies for a Pneumothorax?

Answer 2

Oxygenation and stenting the airways open

1. NRB (keeps constant supply for alveoli)
2. Decompress (needle to get air out)
3. Chest tube
4. Re-expansion pulmonary edema, get that air out!

Question 3

How would JVD be related to a pneumothorax?

Answer 3

Pressures are exerted on the heart because of air in the pleural space.

Question 4

What does sucking outside to in indicate?

Answer 4

Trauma

Question 5

Where are chest tubes inserted?

Answer 5

Around the 5th-7th rib by the intercostal.

Question 6

What is open lung ventilation? (OVA)

Answer 6

Mechanical vent. strategy to min lung injury and improve gas exchange by maintaining the lungs in a open state.

• High PEEP w/lower Vt

Question 7

Inline vs. Closed suction pressures?

Answer 7

1. Inline = 120-150
2. closed = 80 - 120

Question 8

Suction pressures for a chest tube water column?

• hint box thingy on the floor, not the wall.

Answer 8

20-25

Question 9

What does bubbling in the water column mean for a chest drainage tube?

Answer 9

Air is coming through the device and through the water.

Question 10

Safety checks for the chest tube (tube and box)?

Answer 10

• Leak test
• Clamping the chest tube (as close to the body as possible)

Question 11

What should the result be if you seal the system?

Answer 11

no more bubbles, no air should be moving through the device

• if there is, that means a leak?

Question 12

What is Delta pressure?

Answer 12

Pplat - PEEP