Download - Chest Drains
Chest Drains
Pradeep Chockalingam
Physiotherapist
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Definition
Chest drain is a process by which air, blood,
pus, or other secretions are removed from the
chest cavity.
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Types
Chest Cavity Drain (Pleural Space)
Pleural Drain / Tape
Pericardial Drain / Tape
Mediastinal Drain
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Chest Cavity Drain
Pneumothorax
Haemothorax
Haemopneumothorax
Pyothorax
Pyopneumothorax
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Causes
R.T.A.
Fracture Ribs
Barotrauma
Infections
Emphysema, Cystic fibrosis
Blunt and Sharp injuries
Accidentally during some medical procedures
over the chest wall
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Types of Pneumothorax
Simple
Open
Tension
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Site of Drain
Meeting point of
mid-axillary line and
the line drawn from
the nipple (4th or 5th
intercostal space)
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Why 4th or 5th IC space ?
During expiration the diaphragm elevates to the level
of 5th rib
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Underwater Seal Chest Drain
It is a simple mechanism by
which using water & gravity
as an one way valve to allow
the air in the pleural cavity to
escape by bubbling and
preventing it from
re-entering into the pleural
cavity.
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Complications
Blocking of tube
Leaking & surgical emphysema, infection
Shallow breathing
Fear of pain & Pain
Stiff Shoulder & Neck
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Points to be consider
Adequate Pain relief.
Check for water column swing, level &
bubbling.
Check for signs of leak, surgical emphysema,
signs of infection.
Do not lift the drain above the chest level.
Do not clamp the drain.
Treat patient as a whole.
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Physiotherapy Tools
PHYSIO
Breathing
ExerciseCoughing Position
Manual
Tech.RoM
Exercise
CPAP
Triflow
Man.Hyp
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Reference
Ciesla ND & Murdock KR (2000): Lines, tubes, catheters, and
physiologic monitoring in the ICU: Car.pul Phy Ther Journal:
Vol11, No 1, page 16-25
Cystic Fibrosis Trust (2002): Clinical Guidelines for the
Physiotherapy Management of Cystic Fibrosis: Cystic Fibrosis
Trust, ISBN: 0-9540536-4-8
Gallon A (1998): Pneumothorax: Nursing Standards: Vol 13, 10,
page 35-39
Laws D et al (2003):BTS guidelines for the insertion of a chest
drain: Thorax: (2003)58(Suppl 2) page:ii53-ii59 & (2005)60
page:152
Senekal M et al (1995): Penetrating stab wounds of the chest
when should chest physiotherapy commence?: A comparative
study: S Afr j surg: Vol 33,No 2, page: 61-66
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Thanks
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