00:04
Okay, guys,
I know that was a lot of steps.
00:06
But really important to document as
you know, we've set up our system,
we've monitored our patient,
now we get to document.
00:14
So many times when you're
documenting chest tubes,
much of your facility is going to have a
light tronic medical record, for example.
00:22
And typically, there's a flow sheet
that you can choose the chest tube,
and there's lots of components in
there that are already preset for you.
00:29
But a few key things to make sure that
you document, these 6 specifically.
00:35
You want to make sure you document
the chest drainage system,
the catheter securement.
00:40
And don't forget about that
really important air leak,
is there one in there or not?
We want to make sure we
document the site appearance,
what kind of dressing
and also don't forget
to document the characteristics
of the drainage.
00:54
Now these 6 important points should
always be included in your documentation.
00:59
Now, you may see an electronic
medical record like this
and the flow sheet
we just discussed.
01:05
Typically, there's an expansion
arrow where you can drop down
and look at your choices.
01:10
Now take your time as a
new nurse documenting this,
get familiar with these topics
and make sure you look through
and document thoroughly.
01:18
Okay, guys, I know that was
a lot about chest tube care,
but it's a really
important topic.
01:24
And before you go today,
I want to talk about 6
crucial points to take away
in regards to taking care
of a chest tube client.
01:33
So one potential
complication is infection.
01:37
Think about that anytime
you have a foreign object
inserted into a
patient's body cavity,
infection is a huge risk.
01:44
So monitor for the signs
and symptoms of that.
01:48
And especially if it's a new chest tube,
there can be a lot of pain associated.
01:52
So please assess your
client regularly.
01:56
Now next, there can be air
leak at the insertion site.
01:59
Now one key point to think about,
make sure you trace those lines.
02:03
Always trace the
lines in the tubing
and look for any disconnection
in the tubes itself.
02:08
Also a good thing to remember,
check the dressing site,
sometimes that dressing maybe peels
up so we want to check that as well.
02:16
Now when we're talking
about air leaks,
don't forget about
that air leak monitor.
02:21
That's a really
helpful point for us.
02:23
Now, anytime you're
talking about air leaks,
keep a petroleum gauze or
whatever the agency preferences
in regards to air leak coverage
close by your patient's bedside.
02:34
Okay, so we're almost there.
02:36
I want to talk about these last half
of these complications with you.
02:40
One thing that can also happen
is a tubing disconnection.
02:44
So one remedy for
that, if that comes up,
also have sterile
water at the bedside.
02:50
So if a tubing
gets disconnected,
you can take the tubing and plunge
it into the sterile bottle itself.
02:58
Now let's pause a moment on this really
important potential complication.
03:03
Okay guys, are you listening?
Okay, accidental dislodgement.
03:07
Now what I'm talking about
that is not the tubing.
03:11
I'm talking about the chest tube coming
out of the patient's body cavity.
03:16
So you can imagine
if I have a tube,
and it comes out of the
patient's body cavity.
03:22
Now that's there for the lung,
the lung can really
deflate like a balloon.
03:26
Can you imagine how you would
be able to breathe like that?
That is a medical emergency.
03:32
So if a patient has an
accidental dislodgement,
make sure you always keep a vaseline
gauze and occlusive dressing with you.
03:40
Here's a story for you.
03:42
I've had a nurse tell me she was
on the elevator with a patient
and the chest tube came out
of the patient's body cavity.
03:49
So that just tells you always have
a gauze and an occlusive dressing
specifically a vaseline
gauze next to you
and every time you're with
a patient with a chest tube.
04:00
Now if this gets this large, obviously
you've got to call the doctor immediately.
04:06
Now lastly, before you leave, another thing
that can occur is chest tube occlusion.
04:11
So first things first, remember about
that tubing, check if there's any kinks.
04:16
Also,
if you remember from earlier,
make sure that system is below
the level of the patient's chest.
04:22
And if we can't remedy that,
again, call your doctor.
04:25
Thanks for listening.