Chest Tubes & Chest Drainage

Question 1

Chest drainage systems are used to evacuate….?

Answer 1

Blood
Air
Fluid
Pus
Lymph

Question 2

Chest tubes are draining what in a pneumothorax?

Answer 2

Air

Question 3

Why is a tension pneumothorax so dangerous?

Answer 3

If the pressure exceeds atrial filling pressure, then there will be no more atrial filling

Question 4

Chest tubes drain what in a hemothorax?

Answer 4

Blood

Question 5

Chest tubes drain what any hydrothorax?

Answer 5

Fluid

Question 6

Chest tubes drain what in a chylothorax?

Answer 6

Lymph

Question 7

Chest tubes drain what in an empyema?

Answer 7

Pus

Question 8

What is the purpose of the white line on the chest tube?

Answer 8

It is radiodense and helps find the tip of the tube in the most proximal hole

Question 9

What is the name of the most proximal hole on a chest tube?

Answer 9

Sentinel Eye

Question 10

Where is a chest tube normally placed?

Answer 10

Usually at the axillary line and drains posteriorly

Question 11

When is the chest tube removed?

Answer 11

When there is no air leak
Minimum amount of fluid
No longer on suction

Question 12

Look over all of the diagrams for the bottle systems of chest tubes

Answer 12

They are way too complicated to try and explain via text

Question 13

What are some potential flaws of the one bottle system of chest drainage?

Answer 13

Glass bottle could break
Fluid accumulation over time–> increasing pressure
Bottle can tip over

Question 14

Why is there sterile water in the bottom Of a one bottle chest drainage system?

Answer 14

Prevents air from being reentrainment

Question 15

What is the primary difference between the two bottle and three bottle system?
(And no smart asses I’m not talking about just 2 versus 3 bottles)

Answer 15

The 3 bottle system is connected to suction

Question 16

What determines the pressure in a three bottle system?

Answer 16

Depth of straw in bottle 3 and height of water column

Question 17

Which bottle is connected to suction?

Answer 17

3

Question 18

In a 3 bottle system, If you occlude the connection to the patient or the connection between bottles 1-2 or bottles 2-3 what happens?

Answer 18

Way to go, You created a tension pneumothorax

Question 19

If you occlude the suction in a three bottle system what happens?

Answer 19

Pressure builds up until water bubbles out

Question 20

What are the advantages of an integrated chest drainage system?

Answer 20

One-way valve
Evacuate air
Drain and collect fluid
Observe and measure fluid
Monitor for discontinuation
Apply suction
Protect against back pressure

Question 21

What is the purpose of the pop off valve In a chest drainage system?

Answer 21

It pops off in the event of positive pressure accumulation and prevents back pressure into patient

Question 22

What is the purpose of a chest tube?

Answer 22

It equalizes the pressure it is not strictly a drainage system