Transcript When to Use or Not Use By Don Hudson D.O. Breathing Management CCEMT-P

When to Use or Not Use
By Don Hudson D.O.
Breathing Management
CCEMT-P SM
May-16 1
Chest Tubes
• Indications and purpose
• drainage of fluid and air from
pleural space or mediastinum
• used to treat pneumothorax,
hemothorax, hemopneumothorax
and empyema (pus)
• useful in fluid collection
• helpful in respiratory assistance
Breathing Management
CCEMT-P SM
May-16 2
Positioning
Breathing Management
CCEMT-P SM
May-16 3
Chest Tube
Insertion
• Site
• Procedure
.
Complications
Breathing Management
CCEMT-P SM
May-16 4
Assessment of Chest
Tubes
• Respiratory effort and status
• Suction versus water seal method
• Tube placement
•
•
•
•
intact dressing
sutures
signs of infection
loss of tube integrity
Breathing Management
CCEMT-P SM
May-16 5
X-Rays
Breathing Management
CCEMT-P SM
May-16 6
Now What ?
Breathing Management
CCEMT-P SM
May-16 7
Assessment of Chest
Tubes
• Adequate drainage
• quality and amount
• color changes, blood, pus
• Adequate suction
•
•
•
•
maintain “dependent loop”
milking chest tube
placing on water seal
adjustments
Breathing Management
CCEMT-P SM
May-16 8
Do these Work ?
Breathing Management
CCEMT-P SM
May-16 9
How Good are the Small
Tubes ?
• When can you use a
Himlick valve ?
• Why would you use
it ?
• What can you
reasonably expect it
to do ?
Breathing Management
CCEMT-P SM
May-16 10
Complications of Chest
Tubes
• Recurrent pneumothoracies
• Accidental removal
•
•
•
•
•
immediately apply occlusive dressing to site
do not reinsert tube
monitor vital signs closely
ventilate prn
consider diversion to appropriate facility
Breathing Management
CCEMT-P SM
May-16 11
Complications of Chest
Tubes
• Broken collection chamber
• loss of suction
• can cause open pneumothorax
. USE IN AIRCRAFT
. UNIVERSAL PRECAUTIONS
Breathing Management
CCEMT-P SM
May-16 12
Chest Tubes
ATER INSERTION NOW WHAT ?
WHO DO YOU ANSWER TO ?
WHAT TRAINING IS APPROPRIATE ?
Conclusion
Breathing Management
CCEMT-P SM
May-16 13
Some times you really don’t know if
you are coming or going but for now
we’re done. Thank you for your
attention.
Breathing Management
CCEMT-P SM
May-16 14