Today our topic of discussion is Factor Affecting the Chest Drainage.

Factor Affecting the Chest Drainage

Factors Affecting the Chest Drainage

Proper placement of chest catheters-usually two catheters are placed in the chest, one of them is placed anteriorly through the second intercostal space to permit the escape of air rising in the pleural space. The lower catheter is placed posteriorly through the eighth or ninth intercostals space in the maxillary line to drain off serosanguineous fluid accumulating in the lower portion of the pleural space.
Proper placement of drainage apparatus the drainage apparatus for closed chest drainage must always located at a level lower than the patient’s chest. Thus, this helps drainage by gravity. At the same time it prevents backflow of air and fluid in pleural space.
Length of the drainage tubing-drainage tubing which connect the chest catheters to the drainage apparatus should be neither too long nor too short. It should fall in a straight line to the drainage apparatus with no dependent loops. Dependent loops of the tubing, that contain fluids obstruct the flow of air and water into the drainage bottle and create back pressure thus impairing the drainage of air or fluid.

Water Seal Drainage System (Fig. 29.25)

Maintaining the patency of the drainage tubing: Patency of the drainage tubing and the chest catheter are checked frequently. Kinks and pressure on the tubing will cause obstruction in the flow of drainage. Observe the amount of drainage per hour to make sure that the tube is not internally plugged with pus or blood clots. Milking the tube helps to dislodge any clot that is formed in the drainage tubes.
Maintenance of an air tight drainage system. Closed drainage system must be maintained air-tight. The bottles are sealed with right stoppers and all connection of the tubes is taped to ensure its air tightness.
Position of the patient: The patient is placed in a Fowler’s position. This position helps to locate the fluid in the lower portion of the pleural space and drainage thorough the chest tubes, which are placed in the lower chest.
Activity of the patient: The movement of the patient in bed helps to drain the chest. Coughing and deep breathing exercises help the patient to promote lung expansion and expulsion of air and fluid from the pleural space by increasing the intrapulmonic and intrapleural pressure Application of mechanical suction on the water seal drainage system.

Continuous and gentle cough and respirations are too weak to force the air and fluid out of the pleural space through the chest catheters.
In the treatment of empyema thoracic in which the drainage is too thick to drain.
In those patients where air is leaking into the pleural space faster than it can be removing by a water seal apparatus and or to speed up the removal of air or fluid out of the pleural space.

Read more: