Chest Drainage System

USES

• drainage of pleural air/fluid + re-expansion of lung

DESCRIPTION

METHOD OF INSERTION AND/OR USE

• attached to a chest drain
• modern drains incorporate three separate bottles into one unit
• bottle A = fluid trap, can be independently emptied and allows accurate record of drainage amount.
• bottle B = underwater seal drain, maintained at a predetermined level whilst still allowing for drainage of pleural fluid (if bubbling continuously -> bronchopleural fistula)
• bottle C = allows suction to be attached, should be bubbling continuously, depth of water is proportional to the amount of suction below atmospheric pressure (10cm under water -> suction @ 10cmH2O)

OTHER INFORMATION

Safety features

1. first tube connecting drain to drainage bottles must be wide to decreased resistance
2. volume capacity of this tube should exceed ½ of patients maximum inspiratory volume (otherwise H2O may enter chest)
3. volume of H2O in bottle B should exceed ½ patients maximum inspiratory volume to prevent indrawing of air during inspiration
4. drain should always stay at least 45cm below patient (prevention of removed fluid or H2O refluxing into patient)
5. clamp drain when moving
6. H2O level above tube in bottle C determines the amount of suction applied before air drain through tube (safety suction limiting device)
7. if suction is turned off then tubing must be unplugged -> so air can escape into atmosphere (otherwise a tension pneumothorax)

COMPLICATIONS