Chest Tubes

WHAT YOU SHOULD KNOW:

  • A chest tube is also known as chest drain or chest drainage tube. It is a plastic tube that is put through the side of your chest. It is placed to remove air, blood, or fluid from around your lungs. The lungs are covered by two layers of tissue called pleura. Between these two layers is a small space called the pleural space. It normally contains a small amount of fluid, which helps your lungs move easily when you breathe.
    Picture of the normal respiratory system


  • Certain conditions such as infection, heart disease and cancer can cause air, blood, or extra fluid to collect in the pleural space. This causes pressure to increase in your chest, and may cause one of your lungs to collapse (deflate). If this happens, you will have trouble breathing. A chest tube allows your lung to expand (inflate) so you may be able to breathe more easily. You may need to learn how to prevent problems with your chest tube and the skin around it. You may need to learn how to empty the container attached to the chest tube device. Your caregiver will tell you when the chest tube can be removed.

INSTRUCTIONS:

Take your medicine as directed:

Call your primary healthcare provider if you think your medicine is not working as expected. Tell him if you are allergic to any medicine. Keep a current list of the medicines, vitamins, and herbs you take. Include the amounts, and when, how, and why you take them. Take the list or the pill bottles to follow-up visits. Carry your medicine list with you in case of an emergency. Throw away old medicine lists.

  • Antibiotics: This medicine is given to fight or prevent an infection caused by bacteria. Always take your antibiotics exactly as ordered by your primary healthcare provider. Do not stop taking your medicine unless directed by your primary healthcare provider. Never save antibiotics or take leftover antibiotics that were given to you for another illness.

  • Pain medicine: You may need medicine to take away or decrease pain.

    • Learn how to take your medicine. Ask what medicine and how much you should take. Be sure you know how, when, and how often to take it.

    • Do not wait until the pain is severe before you take your medicine. Tell caregivers if your pain does not decrease.

    • Pain medicine can make you dizzy or sleepy. Prevent falls by calling someone when you get out of bed or if you need help.

Ask for information about where and when to go for follow-up visits:

For continuing care, treatments, or home services, ask for more information.

You may need more tests so that caregivers can learn if your chest tube can be removed. Ask your caregiver when to return for these tests.

Ways to help prevent infections and other medical problems with a chest tube:

  • Change your position while lying down. When a chest tube is in place, you may have pain in your chest that feels like burning. Move to a different position in bed as this may decrease your pain.

  • Clean the area of the skin around the chest tube. Ask your caregiver to tell and show you how to do this.

  • Deep breathe and cough. Deep breathing helps to open the air passages in your lungs. Coughing helps to bring up sputum (mucus) from your lungs. You can deep breathe and cough on your own, or with the help of an incentive spirometer.

    • Take a deep breath and hold the breath as long as you can. Then push the air out of your lungs with a deep, strong cough. Put any sputum that you have coughed up into a tissue and throw it away. Take 10 deep breaths in a row every hour that you are awake, even during the night. Remember to follow each deep breath with a cough.

    • An incentive spirometer can help you take deeper breaths. Put the plastic piece into your mouth and take a steady, deep breath in. Hold your breath as long as you can, and then exhale (breathe out). Use your incentive spirometer 10 times every hour that you are awake, even during the night.

  • Drain the chest tube container as often your caregiver has told you to. Write down the date and time, and how much fluid is in the container every time you empty it.

  • Get some exercise. Getting out of bed and walking may help prevent medical problems. Ask your caregiver if you should get up and walk, and how often to do it.

Ways to help prevent problems with the chest tube:

  • Check your chest tube for kinks or loops. Keep the tube close to you when you are lying in bed without lying on it. Do not let loops of tubing hang down the side of your bed. Be sure your tubing is long enough so that you can move and turn in bed without pulling on it.

  • Do not turn knobs or change settings on your device unless a caregiver tells you to.

  • If your chest tube device has water in it, the water should bubble gently, with short periods of no bubbling. If there is a lot of bubbling that does not stop, this may mean that there is a large air leak.

  • Keep the chest tube drainage container below the level of your chest. Keeping the container lower than your chest level will help fluids drain out of it. Doing this will also prevent fluids from going back into your chest.

  • Secure the end of the chest tube to the drainage tube with tape. This will help prevent the two tubes from coming apart.

  • Tape the chest tube to your chest below the bandage. Taping the tube down may help prevent tension (pulling) on the tube. If the tube is pulled on it may move out of place.

Chest tube removal:

  • Your caregiver will tell you when your chest tube can be removed. The chest tube can be taken out when your lung is working as it should. Signs that your lung is working well include little or no fluid draining into the tubing or the collection container. There should be no air leaking from your lung for 24 to 48 hours (1 to 2 days). Your caregiver may clamp the tube for a short time before taking it out. Never clamp the tube yourself.

  • Your caregiver may give you medicine to decrease pain 30 to 60 minutes before the tube is taken out. He will remove the tape and loosen the suture (thread) holding the tube in place, if you have one. You may need to breathe in deeply and hold your breath just before he removes the tube. He will remove the tube and may tighten up the suture to close the opening. He will cover the opening with a special bandage to help prevent air from getting into your chest. After the tube is out, you may need to have a chest x-ray to make sure your lung is working as it should.

Ways to help prevent an infection after the chest tube is taken out:

Keep the area of your skin where the tube was inserted dry. You may secure a bandage over the area where the chest tube was placed. You may take a shower or bath and get this area wet 72 hours (three days) after your chest tube is removed.

CONTACT A CAREGIVER IF:

  • You have a fever.

  • The tubing gets bent, twisted, or the tape comes loose.

  • You see a crack in the collection container.

  • You have pain or swelling in the place where the tube was inserted that gets worse, or does not go away.

  • There is swelling, redness, drainage (pus), or a bad smell coming from the place where the tube was inserted.

  • You have questions about having a chest tube, or you need more supplies at home.

  • You have chest pain or trouble breathing that is getting worse over time.

SEEK CARE IMMEDIATELY IF:

  • The chest tube comes out. If this happens, quickly press a clean, new bandage over the site while waiting for help.

  • The bandage around the tube or over the tube insertion site becomes soaked with blood or fluid.

  • Your chest tube comes apart from the collection container. If this happens, quickly put the end of the tubing into a new, sealed bottle of sterile water while waiting for help.

  • You suddenly feel lightheaded and have trouble breathing.

  • You have new and sudden chest pain. You may have more pain when you take deep breaths or cough. You may cough up blood.

  • Your arm or leg feels warm, tender, and painful. It may look swollen and red.

Copyright © 2012. Thomson Reuters. All rights reserved. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

Learn more about Chest Tubes (Aftercare Instructions)

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