Vaisakh. GI Year MSc. Nursing,AIMS,kochi.

The external surface of the lungs are covered by a thin, smooth serous membrane called the VISCERAL PLEURA.

A similar membrane lines the thoracic cavity, this contains nerve receptors to detect pain called the PARIETAL PLEURA

A Chest tube or Intercostal drainage

is the insertion of flexible plastic tube

through the chest wall into the pleural

space or mediastinum to drain fluid or

air.

To overcome the accumulation of air or fluid in the pleural cavity that might impair ventilation.

Pleural membranes have a vital role in ensuring the lungs are expanded.

Therefore any disruption to the integrity of these membranes or changes within the pleural space,will compromise ventilation.

Adults - 20 Fr - 40FrChildren - 6Fr – 26Fr

Observation

Pain control

Securing the drain

Refractory coagulopathy Diaphramatic hernia Hepatic hydrothorax Pleural space adhesion

Position and fluid levelSuctionChanging dressing and Bottle

Clamping

Drainage slows or stops

Accidental disconnection

Transporting patient

Changing the drainage device

Removing chest tubes

Chest tube malpositioning

Reexpansion pulmonary edema

Hypotention

Infection

Pneumonia

Shoulder disuse(frozen shoulder)