Page 135 - Critical Care Notes

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■ Significant changes in vital signs
■ Increased subcutaneous emphysema
Chest tube removal (when there is no air leak for 24 hr, drainage <100 mL/day,
and CXR shows almost complete lung expansion):
1
■ Premedicate with analgesics ⁄2 hr before removal.
■ Place patient in semi-Fowler’s position.
■ Use Vaseline gauze on a sterile dressing and hold over chest tube site.
Have patient take a deep breath and perform Valsalva maneuver during
expiration → chest tube is removed while rapidly covering the chest tube
insertion site with the gauzed dressing.
■ Perform follow-up CXR.
Intercostal
Rib muscle
Parietal pleura
Visceral pleura
Lung

Chest tube placement between ribs and pleural space of lung.

RESP