contaminate the end of the tubing, the cap, or the open end of the specimen tubes. Cap
the tubes and place them upright in a clean glass provided for this purpose. Label each
tube as directed by the physician.
(6) If drainage of a large amount of accumulated fluid is necessary, assist
the doctor by placing the free end of the tubing in the drainage bottle.
(7) Watch the patient's color; check pulse and respiration. Immediately
report any sudden change, as this may indicate damage to the visceral pleura from a
nick or puncture by the needle.
After the needle is withdrawn, apply a sterile dressing over the puncture
Position patient comfortably (usually Fowler's position).
e. Follow-up Procedures.
Remove equipment from bedside to utility room.
Complete entries on appropriate laboratory request forms as directed.
(3) Send properly labeled specimens with completed request forms to
(4) Measure and record amount of fluid withdrawn and discard this fluid
unless directed otherwise.
(5) Discard disposables, place all linen in hamper, and return appropriate
items to CMS.
(6) Continue to observe patient for respiratory difficulty: persistent cough,
dyspnea, or the presence of blood in the sputum. Take and record vital signs q4h
(every 4 hours), or as ordered.
Obtain post-procedural chest X-rays, if ordered.
(8) Enter the following information on Nursing Notes: date and time,
procedure, by whom performed, amount and type of fluid withdrawn, patient's reactions,
and specimens sent to laboratory.
2-24. CHEST TUBE INSERTION
a. General. Chest tube insertion (tube thoracotomy) is the insertion of one or
more flexible tubes into the pleural space to remove air, blood, or fluid. This procedure
is done by the physician.