Chest Tubes in Children
Medically reviewed by Drugs.com. Last updated on May 6, 2024.
AMBULATORY CARE:
What you need to know about a chest tube:
A chest tube is a plastic tube that is put through the side of your child's chest. A suction device removes air, blood, or fluid from around your child's heart or lung. This will help your child breathe more easily. A chest tube is also known as chest drain or chest drainage tube.
How to prepare your child for a chest tube to be inserted:
- If possible, help your child understand the procedure. Tell him or her why a chest tube is needed. Describe how it is inserted. Explain that medicine will be used to help prevent pain.
- Your child's healthcare provider will tell you how to prepare your child. You may be told not to let your child eat or drink anything for a certain time before the procedure.
- Tell your child's provider about all your child's current medicines. The provider will tell you if your child needs to stop any medicine for the procedure, and when to stop. The provider will tell you which medicines to give or not give your child on the day of the procedure.
- Tell your child's provider if your child has any allergies. Antibiotics may be given to prevent a bacterial infection. Tell the healthcare provider if your child has ever had an allergic reaction to anesthesia or an antibiotic.
What will happen when a chest tube is inserted:
- Your child may be given general anesthesia to keep him or her asleep and free from pain during the procedure. Your child may instead be given local anesthesia or a nerve block. Your child will be able to feel some pressure during the procedure, but he or she should not feel any pain.
- Your child's healthcare provider will make a small incision in your child's chest. A tool is used to make an opening through the chest muscle. The chest tube is inserted slowly until it reaches the pleural space or chest cavity. Your provider may use an ultrasound to guide the tube into place. When the tube is in place, it will be connected to suction and a drainage system.
- Stitches may be sewn into your child's chest wall to hold the tube in place. Medical tape may also be used to secure the tube before it is covered with a bandage.
What your child should expect after a chest tube is inserted:
- Medicines may be given to reduce pain or prevent a bacterial infection.
- An x-ray or a CT scan may be used to make sure the tube is in the right place. Your child may also need an x-ray after the chest tube is removed.
What you need to know about chest tube removal:
- Your child's healthcare provider will tell you when the chest tube can be removed. After heart surgery, the chest tube may be removed within 72 hours. For lungs, the chest tube can be taken out when your child's lung is working normally again. One sign of this is little or no fluid draining into the chest tube. Another sign is no air leaking for 1 to 2 days. Your child may need a chest x-ray to make sure his or her lung is working as it should.
- Your child may be given medicine to treat pain before the tube is removed. The tape will be removed. The stitches holding the tube in place will be loosened. Your child may need to breathe a certain way as the tube is taken out. Your child's provider will remove the tube and may tighten the stitches to close the opening. The area will be covered with a bandage that will stop air from getting into your child's chest.
Risks of chest tubes in children:
Your child may get an infection, or the place where the tube goes in may bleed more than expected. Your child's organs, blood vessels, or nerves may get damaged. He or she could have chest pain after the procedure. He or she may need to have the procedure again if the tube gets pulled out. If your child's condition comes back after treatment, he or she may need another chest tube. The chest tube may not decrease your child's signs and symptoms. The healthcare provider may not be able to insert the tube. If this happens, your child may need to have another procedure or surgery.
Call your local emergency number (911 in the US) if:
- Your child has sudden chest pain.
- Your child has sudden trouble breathing.
Seek care immediately if:
- Your child's chest tube comes out.
- Your child's bandage becomes soaked with blood.
- Your child's stitches have come apart.
Call your child's doctor if:
- Your child has a fever.
- Your child starts to vomit.
- Your child's pain does not go away after pain medicine has been given.
- Your child's skin is itchy, swollen, or has a new rash.
- The area where the tube was placed is swollen, red, or has pus coming from it.
- You have questions or concerns about your child's condition or care.
Care for your child:
- Help your child find a comfortable position. Your child may have pain or discomfort while the chest tube is in. Have him or her lie in a different position to help decrease pain.
- Have your child cough and breathe deeply as directed. This will decrease the risk for a lung infection. Have your child take deep breaths and cough 10 times each hour. Your child should hold a pillow tightly against the insertion site when he or she coughs. Tell your child to take a deep breath and hold it for as long as he or she can. Then let the air out and cough strongly.
Care for your child's chest tube:
- Check the chest tube for kinks or loops. Keep the tube close to your child when he or she is in bed, but do not let your child lie on it. Do not let loops of tubing hang down the side of your child's bed. Be sure the tubing is long enough so that your child can move and turn in bed without pulling on it.
- Keep the suction device below the level of your child's chest. This will help fluids drain from your child's chest to the container below. This will also help prevent fluids from flowing back into your child's chest.
- Make sure the chest tube is secure. The chest tube needs to be securely taped to your child's body. The chest tube may also be taped to the suction device to help prevent the tubes from coming apart.
- Do not turn knobs or change settings on the device unless a healthcare provider tells you to. If the suction device has water in it, the water should bubble gently, with short periods of no bubbling. A lot of bubbling that does not stop may mean air is leaking.
Care for the tube insertion site as directed:
Keep your child's bandage clean and dry. Ask your child's healthcare provider when he or she can bathe.
Follow up with your child's doctor as directed:
Write down your questions so you remember to ask them during your visits.
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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.
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