LibGuides: Clinical Practice Supports: Nursing Skills and Procedures: Chest Tubes

Key Practice Points

Do not milk or strip chest drainage system as this can increase negative intrathoracic pressure.
Clamping of chest tube occurs only when troubleshooting the source of an air leak, or changing the chest drainage system, and should only be clamped for a few seconds.
Ensure suction is performing as ordered and check for air leaks.
Assess insertion site and surrounding skin to confirm securement and comfort.
Dressing recommendations have changed, do not use petroleum-impregnated gauze post-op (e.g. Jelonet).
Monitor and manage drainage, ensuring collection chamber is lower than insertion site (unless using Thopaz+ digital drainage system).
Know the safety measures if chest tube removed from pleural space or becomes disconnected from closed chest drain.
Make sure to provide patient education materials and support.

Skills with Workplace Notes

Insertion and Removal

Dressing Change

Changing Chest Tube Dressing in Adults

General Management & Troubleshooting

Pleural Catheter

Managing an Indwelling Pleural Catheter
CAN-CL-001 Management and Care of Pleural Catheter for Malignant Pleural Effusion
Caring for a Pleural Catheter: A guide for patients and their caregivers
NSHCCP-4014 -- Division of Thoracic Surgery and VG 6A with special thanks to Dr. Simon Houston, Division of Respirology (2021)

Wet and Dry Suction

Heimlich Valve

Atrium Oasis

Video: Oasis Setup and Operation

Medela - Drainage and Thopaz+ Device

To get to and complete a Medela Course: 1. Click the "Add" button to transfer your preferred course to your shopping cart. 2. Click the "Proceed to Cart" button to check out. 3. If you are a returning user, log-in with your personal log-in credentials. If you are a new user, please click on "Create an Account". 4. Back in your shopping cart, click on "Next Step Check Out". 5. Return to dashboard to start your course.

Course: Chest Drain Management
Examines what chest drain is, where and why they are used along with different chest drainage systems. This course provides an excellent introduction to understanding and managing chest drainage.
Course: In Service Course Thopaz+
This video based course talks through step by step how to set up the Thopaz+ device, including tubing and canister connection. Ideally you should have the equipment in front of you to follow the steps or alternatively use the Thopaz+ Simulator App.
Video: Medela Thopaz+ Express In-Service Video
This video will provide you with the info required to set up and operate the most commonly used features on the Thopaz+ Digital Chest Drainage and Monitoring System.

Clinical Practice Supports: Nursing Skills and Procedures