laboratory and clinical booklet - Fort Scott Community College

Name: ____________________
PERFORMANCE CHECKLIST
MANAGING A CHEST TUBE
1. Assess client:
Vital signs, auscultate lungs, pain level, observe chest
wall, assess dressing at insertion site.
2. Ensured that necessary equipment was at client‟s bedside
in case of emergency (i.e., rubber-shod Kelly clamp,
sterile petrolatum gauze dressing, extra drainage
system.)
3. Assess drainage system:
Keep tubing straight or loosely coiled. No kinks in
tubing.
Check all connections between chest tube, drainage,
tubing, drainage collection unit. Should be tightly
sealed/taped.
Observe and document color/description/amount of
drainage, noting any changes in characteristics.
4. Assess water-seal chamber – should be tidaling, air leak
is present if there is continuous air-bubbling.
Water-seal level should be at the appropriate level.
5. Assess suction control chamber (wet system):
Maintain water at ordered level.
Maintain connection to wall suction.
Suction control chamber should have constant bubbling.
6. Assess drainage chamber:
Determine that measurement occurred at end of previous
shift.
Assess amount of additional drainage.
Keep below level of client‟s chest.
Mark level of meniscus at end of shift.
Document total output for your shift.
7. If air leak present (i.e., continuous bubbling in the waterseal
bottle/chamber), checked for location of leak by
occluding chest tube near client‟s chest with rubber-shod
Kelly clamps. Did not leave clamps in place longer than
one minute.
a. If leak in drainage system (i.e., bubbling continued
with clamps in place), checked integrity of
connections & retaped them. Replaced drainage
system if necessary.
b. If leak at chest tube insertion site (i.e., bubbling
stopped with clamps in place), reinforced the
occlusive chest dressing. Notified physician if leak
continued.
10
Date: __________________
S U
Comments