(12) Prepare for chest tube insertion, if necessary.
(13) If a drainage system is unavailable, improvise or use a manufactured
one-way flutter valve (Heimlich).
(14) Attach a flutter valve to the needle valve assembly in this manner.
(a) Cut the finger casing from the sterile glove, cutting off the fingertip
(b) Tie or tape finger casings securely to the needle. (This acts the
same as the Heimlich valve.)
When you are expiring air (removing it), air passes out through the needle
assembled and the improvised flutter valve. When you are inspiring air
(forcing air in), the improved flutter valve collapses against itself and the
needle hub. This prevents air from entering into the pleural space.
Tape the needle hub to the patient without closing off the flutter
CHEST TUBE INSERTION
Chest tubes are placed so that air and blood can be removed from the
intrathoracic cavity. Place the chest tube in the appropriate space so that air is
removed and the condition is relieved. Chest tubes are placed so that gravity aids
suction in fluid removal.
a. Indications for Chest Tube Insertion. Three conditions commonly require
the insertion of a tube into the chest. The conditions are hemothorax, large
pneumothorax, and tension pneumothorax. Hemothorax is the accumulation of blood in
the pleural cavity. Large pneumothorax is the presence of pus or air in the pleural
cavity. The amount of trapped air or gas determines the degree of lung collapse. In
tension pneumothorax, air in the pleural space is under higher pressure than air in the
adjacent lung and the vascular structures. A patient with large or tension pneumothorax
must have prompt treatment, or he will suffer fatal pulmonary and circulatory
Pneumothorax is the presence of air or gas in the pleural cavity, a situation
that may occur spontaneously.
b. Equipment for Chest Tube insertion. Equipment needed includes the
BetadineR or another solution in preparing the site for chest tube