WATER SEAL DRAINAGE

Sets up the Water seal Drainage SystemPneumothorax - when air collects in the pleural space (anterior chest 2nd ICS)Hemothorax – When blood or fluid collects in the pleural space (posterior chest 8th or 9th ICS)

Ist bottle- collecting chamber2nd bottle- water seal chamber3rd bottle- suction control chamberPreparatory Phase:

1. Prepare the materials needed: a. water seal chamber (3 bottles, 2 bottles and 1 bottle)b. tubingc. tape, gauge, suction (if needed)d. 2 rubber tip clamps

2. Identify the client and explain the procedure3. Provide privacy4. Asses for the ff:

Breath sounds Chest movementRR Dressing site (bleeding/foul odor)Depth of breathing

Performance Phase

1. Fill the water seal chamber with sterile water to the level equaling to 3cm water.2. Fill the suction control chamber with sterile water up to 20 cm level (if intermittent suction is needed)3. Attach the catheter from the pleural space (the patient) to the tubing coming from the collection chamber of the water seal system4. Tape securely for it to be air tight (negative pressure)5. Connect the Suction control chamber tubing to the suction unit (if suctioning is used)6. Turn the suction unit on (if suction is used)7. Observe for the appearance of bubbles in the suction control chamber.8. Mark the original fluid level with tape (date, time and amount) on the outside drainage unit hourly, or every shift 9. Check the tubing for any kink 10. Assist patient to assume position of comfort (semi-fowlers)11. Encourage patient to change positions frequently every 2 hours (for proper draining of the secretions)12. Milks the tubing in the direction of drainage chamber every 2 hoursMilking=increased (-) pressure13. Check the patency of tubing (check for presence of leaks)

14. Monitor/ observe function of the fluid level in the water-seal chamber.Fluctuations=reflects pressure changes during respiration (5-10 cm or 2-4 inches)

15. Check for constant bubbling in the water seal for it will indicate leaks of air in the drainage system.Intermittent bubbling=normalAbsence of bubbles= obstruction/ kinkContinuous bubbling= presence of leaks

16. Reports exercise bubbling in the water seal chamber immediately.17. Encourages client to breathe deeply and cough at frequent intervals.18. Maintains drainage apparatus at a level lower than the patient’s chest.