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Ateneo de Naga University: College of Nursing

The document discusses chest tube thoracostomy (CTT), including its indications, parts, and procedure. CTT is done to drain fluid, blood, or air from around the lungs due to various chest conditions like pneumonia, injury, or surgery. It involves inserting a chest tube that connects to a drainage system with collection chambers to monitor output and a water seal chamber to allow air exit during exhalation. The chest tube comes in large or small bore sizes and has a tapered tail end that connects to suction or drainage equipment depending on whether suction is needed. CTT drainage systems carefully monitor fluid levels and bubbling to ensure proper chest tube function and patient comfort.

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Renie Serrano
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79 views3 pages

Ateneo de Naga University: College of Nursing

The document discusses chest tube thoracostomy (CTT), including its indications, parts, and procedure. CTT is done to drain fluid, blood, or air from around the lungs due to various chest conditions like pneumonia, injury, or surgery. It involves inserting a chest tube that connects to a drainage system with collection chambers to monitor output and a water seal chamber to allow air exit during exhalation. The chest tube comes in large or small bore sizes and has a tapered tail end that connects to suction or drainage equipment depending on whether suction is needed. CTT drainage systems carefully monitor fluid levels and bubbling to ensure proper chest tube function and patient comfort.

Uploaded by

Renie Serrano
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as DOCX, PDF, TXT or read online on Scribd
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ATENEO DE NAGA UNIVERSITY

COLLEGE OF NURSING
Ateneo Avenue, Naga City 4400
S/Y 2020-2021

1. Indications of CTT
 Pneumothorax: Open or closed; simple or tension.
 Hemothorax.
 Hemopneumothorax.
 Hydrothorax.
 Chylothorax.
 Empyema.
 Pleural effusion.
 Patients with penetrating chest wall injury who are intubated or about to be
intubated.
2. Chest tube thoracostomy commonly referred to as “putting in a chest tube”, is a
procedure that is done to drain fluid, blood, or air from the space around the lungs. This
procedure may be done when a patient has a disease, such as pneumonia or cancer,
that causes extra fluid to build up in the space around the lungs (called a pleural
effusion). A chest tube may also be needed when a patient has had a severe injury to
the chest wall or surgery that causes bleeding
around the lungs (called a hemothorax). Sometimes, a patient’s lung can be accidentally
punctured, allowing air to gather outside the lung, causing its collapse (called a
pneumothorax).

3. Parts of CTT

1. Collection chamber: The chest tube connects directly to the collection chamber,
which collects drainage from the pleural cavity. The chamber is calibrated to
measure the drainage. The outer surface of the chamber has a “write-on”
surface to document the date, time, and amount of fluid. This chamber is
typically on the far right side of the system (Teleflex Medical Incorporated,
2009).
2. Water-seal chamber: This chamber has a one-way valve that allows air to exit the
pleural cavity during exhalation but does not allow it to re-enter during
inhalation due to the pressure in the chamber. The water-seal chamber must be
filled with sterile water and maintained at the 2 cm mark to ensure proper
operation, and should be checked regularly. Fill with additional sterile water as
required. The water in the water-seal chamber should rise with inhalation and
ATENEO DE NAGA UNIVERSITY
COLLEGE OF NURSING
Ateneo Avenue, Naga City 4400
S/Y 2020-2021

fall with exhalation (this is called tidaling), which demonstrates that the chest


tube is patent. Continuous bubbling may indicate an air leak, and newer systems
have a measurement system for leaks — the higher the number, the greater the
air leak. The water-seal chamber can also monitor intrathoracic pressure
(Teleflex Medical Incorporated, 2009).
3. Wet or dry suction control chamber: Not all patients require suction. If a patient
is ordered suction, a wet suction system is typically controlled by the level of
water in the suction control chamber and is typically set at -20 cm on the suction
control chamber for adults. If there is less water, there is less suction. The
amount of suction may vary depending on the patient and is controlled by the
chest drainage system, not the suction source. Monitor the fluid level to ensure
there is gentle bubbling in the chamber. A dry suction system uses a self-
controlled regulator that adjusts the amount of suction and responds to air leaks
to deliver consistent suction for the patient. If suction is discontinued, the
suction port on the chest drainage system must remain unobstructed and open
to air to allow air to exit and minimize the development of a tension
pneumothorax (Teleflex Medical Incorporated, 2009).
4.
Chest tubes look like very large, plastic straws. They have three main areas:

 The tip, which contains drainage holes.

 The body, which has markings that indicate how far a doctor has inserted
the tube.

 The tail, or end, which tapers slightly for connection to a suction or


drainage system.

Generally, chest tubes divide into two size varieties: large-bore and small-bore.

A large-bore chest tube is 20 Fr or larger, while a small-bore chest tube is smaller
than 20 Fr.
ATENEO DE NAGA UNIVERSITY
COLLEGE OF NURSING
Ateneo Avenue, Naga City 4400
S/Y 2020-2021

Smaller tubes are also available and are known as pleural catheters. Doctors will
often tunnel them in a vein or carefully place them under the skin of the chest
for long-term use.

A pleural catheter may be necessary for a person who has a continual buildup of
pleural fluid due to chronic infection, cancer, or liver disease.

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