Infant Chest Drainage Systems The most prominent feature of infant chest drainage units is the smaller collection chamber that holds less drainage than an adult unit. The patient tubing may have a narrower inner diameter compared with adult drains and usually has smalle After a chest tube is placed, it's connected to a drainage system like an Atrium (which I'll be referencing in this post). This closed system consists of three chambers : collection, water-seal, and suction control An underwater seal chest drainage system is used to restore proper air pressure to the lungs, re-inflate a collapsed lung as well as remove blood and other fluids. The system is a two-chambered or three-chambered plastic unit with vertical columns bringing measurements marked in milliliters
Chest tube drainage systems are typically used in operating rooms, ICUs, and the emergency department. In selecting a chest tube drainage system, many hospitals prioritize systems that provide reliable, uninterrupted drainage of the chest cavity, easy setup, quiet operation, and advanced monitoring features to improve chest drainage management Chest Tube Drainage System Monitoring and Care Maintaining and troubleshooting a patient's chest tube keeps the chest tube functioning properly and prevents infection. As part of this process, the nurse is responsible for making respiratory and thoracic assessments, obtaining vital signs that reflect effectiveness of therapy or impending complications, and knowing the appropriate interventions t The chest tube is connected to a closed chest drainage system, which allows for air or fluid to be drained, and prevents air or fluid from entering the pleural space.If air is in the pleural space, the chest tube will be inserted above the second intercostal space at the mid-clavical line
Chest drains also known as under water sealed drains (UWSD) are inserted to allow draining of the pleural spaces of air, blood or fluid, allowing expansion of the lungs and restoration of negative pressure in the thoracic cavity. The underwater seal also prevents backflow of air or fluid into the pleural cavity Components of the Chest Tube Drainage SystemSuction controlchamberWater Seal ChamberCollection chamber 37. Suction Control ChamberThe use of suction helps overcomean air leak by improving the rate of airand fluid flow out of the patient.Lower the water content, lower thesuction. Raise the water level, raisethe amount of suction A chest tube can help drain air, blood, or fluid from the space surrounding your lungs, called the pleural space. Chest tube insertion is also referred to as chest tube thoracostomy. It's typically.. A chest tube is connected to a closed chest drainage system, which allows for air or fluid to be drained and prevents air or fluid from entering the pleural space. Because the pleural cavity normally has negative pressure, which allows for lung inflation and deflation, any tube connected to it must be sealed so that air or liquid cannot enter the space where the tube is inserted (Bauman & Handley, 2011; Rajan, 2013)
Replace the chest tube system. 4. Place a sterile dressing over the disconnection site. 2. Place the tube in a bottle of sterile water. If the chest drainage system is disconnected, the end of the tube is placed in a bottle of sterile water held below the level of the chest with a Chest Tube and a Closed Chest Drain ›Before troubleshooting a CT and a CCD, the clinician should be familiar with the following: •Anatomy and physiology of the thorax, particularly the pulmonary system A system for draining the chest cavity of a patient subjected to a traumatic chest injury and/or to surgery within the chest. The system includes a small, portable suction device and a chest tube with an improved terminal structure. A number of embodiments of the suction device are disclosed; the first (with two variations) a small, completely disposable, bottle-shaped assembly comprising a. After a chest tube is inserted, a nurse trained in chest-tube management is responsible for managing the chest tube and drainage system. This entails monitoring the chest-tube position, controlling fluid evacuation, identifying when to change or empty the containers, and caring for the tube and drainage system during patient transport Managing a Chest Tube and Drainage System. Ericha Ridhowati. A 70-year-old woman was admitted to the hospital with breathing difficulty six weeks after undergoing a gastrectomy for stomach cancer. The physician ordered a chest x-ray, which showed a pleural effusion (ie, excess fluid in the pleural cavity) ( Figure 1)
drainage unit directly to the chest tube. Any drainage from the chest flows into this chamber. The collection chamber is calibrated and has a write-on surface to allow for easy measurement and recording of the time, date, and amount of drainage. WATER SEAL CHAMBER. The middle chamber of a traditional chest drainage system is the water seal. The. Chest Tubes A chest tube is a hollow plastic tube that is inserted into the chest cavity to remove or allow the drainage of fluid, blood, or air from that portion of the chest cavity They are removed when drainage becomes minimal Drainage is marked on the collection chamber and documented every 8 hours. 2. Chest tubes (continued) WCMC uses the. The chest drain bottle forms an underwater seal drainage system. The drainage tube is submerged to a depth of 2 cm in the water of the collection chamber. This underwater seal creates a one-way valve through which air is expelled from the pleural space and prevented from re-entering during the next inspiration . The nurse is responsible for monitoring the patient and chest tube drainage system while maintaining the chest tube system. Therefore, the nurse must know for the NCLEX exam how a chest tube system works, what to do in you note bubbling, what to do if.
24/7 Drain Technical Support. In the US and Canada: 1-800-528-7486. Getinge leads the chest drainage industry with the most comprehensive educational materials, superior service, and 24-hour technical support for the US and Canada. Below, you'll find personal guides to wet and dry suction chest drainage, setup and operation videos, printable. The tube will be connected to the chest drainage system and may be connected to suction. In the trauma setting, an initial output of 1500 mL or 200 mL/hr over 4 hours is an indication to perform a thoracotomy since such high output is likely a vascular injury that requires surgical repair Effect of two chest tube clearance protocols on drainage in patients after myocardial revascularisation surgery. Heart and Lung 1991;20:125-130. Wallen M, Morrison A, Gillies D, O'Riordan E, Bridge C, Stoddart F. Mediastinal chest drain clearance for cardiac surgery. Cochrane Data- base of Systematic Reviews 2002 -Drain system blocked -Chest tube blocked or misplaced -No air or fluid in pleural cavity. Is There an Air Leak? •Air bubbling in the underwater seal indicates an air leak. •If bubbling continues on suction when tube is clamped near patient there is a leak in th Chest tube have an end hole (proximal, toward the patient) and a series of side holes. The number of side holes is generally 6 on most chest tubes. The length of tube that has side holes is the effective drainage length. Chest tube thoracostomy drainage system, Image credit: RCH. A chest drainage system is typically used to collect chest drainage
clamping method with booted (or padded) chest tube clamp. • If leak is in the tubing, replace the unit. • If the leak is at the insertion site, remove the chest tube dressing and inspect the site. Make sure the drainage ports have not pulled out beyond the chest wall. If you can not see or hear any obvious leaks at the site, the leak is. 1. Never clamp a chest tube if the patient has a continuous air leak, as this may cause a tension pneumothorax. a. If the chest tube becomes disconnected from the drainage system, reconnect immediately. b. If reconnection is impossible, it is preferable to allow the chest tube to act as an open pneumothorax the chest tube is in place and the lung reexpands.The client may be extremely dyspneic and anxious and may need reassur-ance that this invasive procedure will provide relief. •Gather all needed supplies, including thoracostomy tray, in-jectable lidocaine, sterile gloves, chest tube drainage system
Tube thoracostomy, or chest tube placement, is a commonly performed surgical procedure during which fluid, blood, and/or air are drained from the chest cavity. Traditional methods involved a 3-bottle drainage system that was prone to accidental disconnections and blockages Argyle™ chest drainage systems are sterile, crystal clear glass bottles with accurate graduations. Argyle™ Thora-Seal™ III Chest Drainage Unit The Argyle™ Thora-Seal™ III chest drainage unit (CDU) is a wet suction CDU used to reestablish negative pressure within the pleural space The chest tube is connected to a closed chest drainage system, which allows for air or fluid to be drained, and prevents air or fluid from entering the pleural space. If air is in the pleural space, the chest tube will be inserted above the second intercostal space at the mid-clavical line Chest drainage systems One-chamber-system. The simplest system that is sufficient for chest drainage is a one-chamber system. It uses either a Heber-drain or an active suction source and comprises a single collection canister. For active or passive air evacuation, a water seal component is attached. To ensure that all air is sucked out when.
FIG. 10 describes in broad terms the manner of insertion of a drainage chest tube through the use of a trocar as is known in the art. FIG. 11 shows in broad terms the arrangement of the basic components of the chest tube drainage system of the present invention and its placement within the chest of a patient. 3 patient is ready to have the chest tube removed, and during chest tube removal. 1,14,15,21,29 EQUIPMENT Disposable Setup (Wet and Dry Systems) † Disposable chest-drainage unit † Gloves † Suction source and regulator † Connecting tubing † 1-L bottle of sterile water or normal saline (for systems A CHEST TUBE is inserted to remove air, blood, or excess fluid from the pleural space and reexpand the involved lung. If your patient has a traditional water-seal chest drainage unit (CDU), you'll need to manage the system. DO * Keep the system closed and below chest level Chest Tube Systems. a. Pleur-Evac chest drainage system (1) One-piece molded plastic unit that duplicates the three-chambered system (2) Cost effective (3) There must be bubbles flowing in the suction control portion of the unit to provide suction to the patient. b. Pleur-Evac Set Up (1) Fill water seal chambe A chest tube is a hollow plastic tube which is inserted into the chest cavity to drain air or fluid. Fluid in the chest may be blood (such as following surgery or trauma), pus (from an infection such as pneumonia), serous fluid, or contain cancer cells. Chest tubes are often inserted after lung surgery to remove fluids during healing
After a chest tube has been inserted, a nurse trained in chest-tube management is responsible for managing the chest tube and drainage system. This entails caring for the tube and drainage system when transporting the patient, changing or emptying the drainage container, controlling fluid evacuation, being able to identify a bronchopleural. The tube is attached to a drainage system to facilitate the movement of the abnormal fluid/air out of the chest. The tube remains in place until it is no longer needed or becomes nonfunctional (3). According to chest tube nursing care experts, chest tubes are generally divided into three categories based on size and method of insertion: large. 2. Describe the risks/complications associated with chest tubes and chest drainage units (CDUs). 3. Identify how to prepare/assist with the insertion of a chest tube. 4. Describe the monitoring of chest tubes and chest drainage systems. 5. Describe considerations in caring for the patient who has a chest tube, including chest tube maintenance. 6 . Do not clamp the chest tube during transport. When assisting in the chest tube's removal, instruct the patient to perform a gentle Valsalva maneuver or to breathe quietly
The guide tube is then connected to a standard chest drainage system. Located within the guide tube, a guidewire featuring a distal loop moves backward and forward in the chest tube via a proprietary drive system to prevent clot formation. We call this active tube clearance, Boyle comments Decreased chest-tube drainage. • Absence of bubbling in the water-seal chamber during expiration. • Improved chest X-ray findings. Before starting chest-tube removal, inform the patient that the chest tube will be removed, and briefly describe the steps involved. Make sure the patient is premedicated to relieve pain and ease anxiety the drainage system below the chest level (as close to the floor as possible). 15. If the tube becomes disconnected, cut off the contaminated tips of the chest tube and tubing, insert a sterile connector in the chest tube and tubing, and reattach to the drainage system. Otherwise, DO NOT clamp the chest tube for more than one minute during. at home with a chest drain. How do I look after my chest drain? We will explain how the portable drain system works before you go home. Please ask any questions if you are uncertain. The portable drain system comes with a strap, so you can wear it over your shoulder or as a belt. If you will need to empty the drain your nurse will show you how.
Chest Tube Management Simulator. Increase student confidence regarding chest tube care with our one-of-a-kind Chest Tube Management Simulator. This training tool gives students hands-on opportunities to practice checking for tidaling and changing drainage canister systems. They can also train on changing chest tube dressings Bubbling occurs in the water seal chamber when air is entering the chest drain. When you first apply suction, there should be a little bubbling in the water seal as air is pulled through from the collection chamber. If no other air enters the system, the bubbling should soon stop. Bubbling continues when air is entering the system Overview Chest tube is inserted through chest wall into pleural space, in order to: Drain fluid, blood, or air Pleural Effusion Hemothorax Pneumothorax Post-Op drainage Establish negative pressure (one-way valve) Facilitate lung expansion Nursing Points General Setup Chest tube - varying sizes Holes in end Secured with suture Drainage system Tubing Collection chamber (2000 mL [ . Suction is not initially routinely employed: instead the tube is attached to the drainage system that contains a valve mechanism to allow air and fluid to exit but prevents air or fluid from entering the pleural cavity from the outside (2) Reestablish a closed drainage system. (3) Remove clamps, if applied. (4) Notify the professional nurse/physician, as indicated. (5) Observe the patient for respiratory distress. n. As indicated, provide emergency care to the patient if the chest tube becomes disconnected from the drainage system. (1) Clamp the chest tube
Electronic drainage systems have shown increased agreement rate concerning clinical decision making regarding chest tube removal [ 2]. Besides adding objectivity to the clinical decision of chest tube removal, electronic drainage systems have shown superiority to traditional drainage systems in a limited number of studies The few situations in which chest tubes may be clamped briefly (i.e., less than a minute) include locating the source of an air leak, replacing the chest drainage system, determining whether a patient is ready to have the chest tube removed, and during chest tube removal. 1,14,15,21,2 흉관배액(chest tube drainage)의 목적, 원리 및 간호 1. 1. 흉관배액의 목적. 흉막강 내 비정상적으로 존재하는 공기 또는 체액 를 제거하고 폐가 재팽창될 수 있도록 흉강내 압력을 정상화시키기 위함이다.-공기 를 배출시키기 위해서는 흉관을 2~3 번째 늑간 으로 삽입하여 전방을 향해 위치하도록 한다 chest tube a tube inserted into the thoracic cavity for the purpose of removing air or fluid, or both. Chest tubes are attached to a closed drainage system (see illustration) so that normal pressures within the alveoli and the pleural cavity can be restored. These pressures are essential to adequate expansion and reinflation of the lung A chest tube is a thin, plastic tube that a doctor inserts into the pleural space, which is the area between the chest wall and the lungs. Doctors may need to use a chest tube for many purposes.
Wound suction drainge system surgical flat chest tube Specfications: Name Silicone Suction Reservoir and Flat drain Material Medical Grade Silicone Material Ball Volume 100ml, 200ml ,400ml Tube Size F10, F16 Component Ball, drainage tube and clamp connector Certificate CE&ISO13485 MOQ 10,000 pcs Supply Ability 50,000 pcs per day Sterile EO gas Caution Disposable, for single use only Product. Chest tubes and their accompanying pleural drainage units continue to present challenging questions regarding their optimal use. Appropriate chest tube size selection to accommodate the clinical situation is key, especially in the setting of large pleural air leaks lest a tension pneumothorax ensue. Connection of an appropriate pleural drainage unit to the chest tube is equally important to. Oxygenation & Circulation - Chest Tube Drainage System How should the nurse transport or ambulate a client with a chest tube drainage system? The nurse should disconnect the drainage system from the suction apparatus before moving the client and make sure the air vent is open
CHEST DRAIN SYSTEMS and THORACOCENTESIS Normally used is the 3-bottle system with suction 1st bottle: fluid drained from the patient slowly fills up this chamber 2nd bottle water seal bottle: functions as a valve. 2 cm of water is usually not too much (i.e allows air to escape the first bottle 872 chest tube drainage system products are offered for sale by suppliers on Alibaba.com, of which tracheal cannula accounts for 9%, medical rubber accounts for 1%. A wide variety of chest tube drainage system options are available to you, such as ce, msds. You can also choose from 3 years, 1years chest tube drainage system, as well as from. The drainage system most often used with tube thoracostomy functions as a three-bottle system , which provides a one-way water seal, a collection chamber for fluid, and a pressure regulator. Common complications of chest tube placement include malpositioning (the most common complication), recurrent pneumothorax, infection (including empyema. If the chest tube comes out, you'll need to take an occlusive dressing and put tape on THREE sides of the dressing, leaving the fourth side open and put it over the wound. Then, call for help. You MUST make sure air can get out of the pleural space, that's why you need to leave one side of the occlusive dressing open 10. Attach drainage system to chest tube when directed by physician. 11. Tape all tubing connections at chest tube to chest drain unit securely with water-proof tape. NOTE: Connections from chest tube to drainage tubing must be secured with waterproof tape wrapped in a spiral fashion extending 5 cm on each side of connection
If the chest tube drainage collection system is broken or upset at any point, the entire system should be replaced. The tube should be briefly clamped while exchanging systems to avoid air. Tube thoracostomy, or chest tube (CT) placement, is often indicated for the treatment of pneumothorax (PTX) and/or hemothorax (HTX). Although there is generally agreement among surgeons on the indications and technique for CT insertion, there is little consensus on the subsequent management of these tubes once placed The Single-Bottle Water-Seal System (1) Connecting or drainage tubing joins the patient's chest tube with a drainage tube that enters the drainage bottle. (2) The end of the glass rod is submerged in water, extending about 2-3 cm below the water level(The higher the fluid level, the more pressure it takes t The skin around your chest tube is red, puffy, or feels warm or painful when you touch it. Drainage is coming from around your chest tube site. You have pain that isn't eased by your pain medication. More fluid is draining from your chest tube than usual. The color or thickness of the fluid draining from your chest tube changes How do Chest Tube Drainage Systems work? A chest drain tube also called the thoracic catheter is a flexible tube made of plastic that is inserted through chest wall into the pleura in order to remove air, fluid or pus from the thoracic cavity. These tubes are also called the intercostal catheters
The chest tube drainage system used on Earth relies on a wet seal to prevent back flow and provide an indication of air leaks. This wet seal relies on a distinct air-water interface and does not function without gravity. Therefore, there is a need for a system that provides suction and chest tube drainage, while preventing back flow and. Monitor chest tube drainage system. Monitor for subcutaneous emphysema. Documentation Guidelines. Physical findings: Breath sounds, vital signs, level of consciousness, urinary output, skin temperature, amount and color of chest tube drainage, dyspnea, cyanosis, nasal flaring, altered chest expansion, tracheal deviation, absence of breath sound
Here are the basic steps of chest-tube removal: 1. Discontinue wall suction from the chest drainage unit. Some literature suggests you should do this at least 24 hours before tube removal to eliminate a possible air leak. 2. To reduce pain caused by chest-tube removal, premedicate your patient as ordered; allow adequate time for the drug to. chest tube and drainage tubing Debrie ng The leak in the chest drain set needs to be identi ed and repaired, as it is not working and the pneumo-thorax has reoccurred. It is important to check connections that are taped together are in fact gas tight. An easy check is to clamp the chest tube for a few seconds while the system is on suction 1-bottle system. chest drain is connected by collecting tubing to a tube approximately 3 cm under water (the seal) in the underwater-seal bottle. another vent tube is open to atmosphere. pleural pressure greater than +3 cm water will force air or fluid from the pleural space into the bottle while negative pressure in the pleural space will suck. Chest Tube Management • Clinical Indications • Anatomy and Physiology overview • Chest tube set-up • Patient and chest tube management Atrium Chest Drainage System • Three Basic Components: A. Suction control B. & C. Water seal D. Collection Chambers. e-Module module heade Prepackaged chest tube tray (sterile towels, 4 × 4 gauze pads, 3-0 silk suture, curved hemostats, a no. 11 or 15 scalpel, scissors, a needle holder, antiseptic solution, antibiotic ointment, 1% lidocaine, 3-mL syringe, 25-gauge needle); sterile gloves, mask, eye protection, hat, gown, suction-drainage system (eg, the Pleur-Evac system)
A chest tube is essentially a device used to drain air or fluid from the pleural space in order to restore the lungs to normal function. The PleurEvac is a commonly used chest tube system which contains three chambers: 1) the collection chamber; 2) the water seal chamber; and 3) the suction control chamber Chest Tube Drainage (cont'd) Dry suction drainage system --Closed, one-way drainage system. Orange accordion-like object visible when suction applied. Wall suction controls the rate of air flow. Thoracic pressure is determined by the pressure of the wall suction and the level of the water in the drainage system By delivering precise data monitoring and automated chest tube clearance in a digital system, Thoraguard is designed to improve clinical decision-making and patient safety. Thoraguard transforms surgical drainage in cardiothoracic surgery with digital intelligence
Underwater-seal chest drainage is a closed (airtight) system for drainage of air and fluid from the chest cavity. (1) The underwater-seal system is established by connecting a catheter (chest tube) that has been placed in the patient's pleural cavity to drainage tubing that leads to a sealed drainage bottle If a chest drainage system is disconnected, the nurse may place the end of the chest tube in a container of sterile saline or water to prevent air from entering the chest tube, thereby preventing negative respiratory pressure. The nurse should apply an occlusive dressing if the chest tube is pulled out not if the system is disconnected NEONATAL / PEDIATRIC CHEST TUBE PLACEMENT (Neonatal, Pediatric) 6 Percutaneous Chest Tube Insertion - Method #1 . If available, the percutaneous chest tube insertion is the preferred method. It is easier, less invasive, safer, and leaves less of a scar. The safety pneumothorax system includes a blunt, multi-side holed, spring-loaded inne
If bubbling is observed in the underwater seal drain, the chest tube should never be clamped. A non-bubbling chest drain should not usually be clamped except momentarily in the event of its being disconnected, if there is damage to the drainage bottle, or to locate a leak in the drainage system (Henry et al, 2003; Laws et al, 2003; Munnell. chest tube drainage and to help answer questions which may come up from time to time. It is provided as an educational service of Atrium, the leading producer of chest drainage systems. This booklet has been prepared as an educational aid only and is not intended to replace any medical or nursing practices or hospital policies. Due to numerou Available in sizes ranging from infant to adult, chest tubes use the French sizing system—the larger the size, the larger the tube. Generally, larger tubes are used to drain blood and transudate, while smaller tubes are for air removal. Adults commonly require tube sizes between 24 and 40 French PleuraFlow Active Clearance Technology (ACT; ClearFlow) is a chest drain that incorporates a tube clearance system. It comprises a silicone chest tube and the PleuraFlow clearance apparatus. The PleuraFlow clearance apparatus is a PVC guide tube that is used to channel drained blood, fluid and air to the. Notify the physician immediately if the chest tube dislodges, a sudden air leak occurs, significant unexpected drainage occurs, or if the client is experiencing dyspnea. Caution all personnel to maintain upright position of the chest tube drainage system and to keep it stable, often hooked to the bed
Then, a chest tube of 32 Fr. was inserted in the pleural space, after which, the tube was connected to the chest drain system. The natural course of the initial air leaks and pressure fluctuation was recorded in the device for later analysis. After the test procedure, the two pigs were injected with a bolus of potassium chloride into the heart. water- seal chest tube drainage system.. Methodology: A descriptive study which was using the quantitative design. The study was conducted in Alhariri ,Alyarmouk, and Alkindy teaching hospitals starting from October 10th 2012 up to the September 30th 2013. T
• If you have increased pain where tube is inserted. • If you become MORE short of breath • If you develop a fever greater than 100.5º. • When the drainage decreases to less than 20 ml's in a 48 hour period • If there is fluid leaking around the chest tube. • If you have any questions or concerns 15. Answer: C. Place the end of the chest tube in a container of normal sterile saline. If a chest drainage system is disconnected, the nurse can place the end of the chest tube in a container of normal sterile saline to prevent air from entering the chest tube, thereby preventing negative respiratory pressure The water seal chamber is the one-way valve that allows air to leave the pleural space, as with a pneumothorax. If removing excess air is the goal of the chest drain then the water seal chamber may bubble inconsistently, mainly on inspiration, as the air leaves the chest. If the water seal is continuously bubbling, you should suspect an air leak A chest tube is also known as chest drain or chest drainage tube. It is a plastic tube that is put through the side of your child's chest. It uses a suction device to remove air, blood, or fluid from around your child's heart or lung. A chest tube will help your child breathe more easily
Care of the chest tube, including milking the tube if ordered, measuring chest tube output, and changing the chest tube drainage system, should never be delegated to unlicensed assistive personnel. 23 The patient has a chest tube for a pneumothorax. Assessment revealed no continuous bubbling in the water-seal chamber Like any closed system with air and tubing, chest tube drainage systems have intrinsic compliance. The larger the collection bottle and the longer the tubing, the more backflow can be generated on inspiration. In some situations, as much as 60 ml of air may re-enter the pleural space on inspiration
Your personal guide to Managing Dry Suction Chest Drainage is a quick and easy reference to help extend your understanding of dry suction chest tube drainage and to help answer questions which may come up from time to time. It is provided as an educational service of Atrium, the leading producer of water seal chest drainage systems. This bookle Cantin L, Chartrand-Lefebvre C, Lepanto L, et al. Chest tube drainage under radiological guidance for pleural effusion and pneumothorax in a tertiary care university teaching hospital: Review of 51 cases. Can Respir J 2005;1:29-33. Manzanet G, Vela A, et al. A hydrodynamic study of pleural drainage systems: some practical consequences
3. What do you do if a chest tube becomes disconnected from the drainage system, or from the patient? if the chest tube and drainage system become disconnected, air can enter the pleural space, producing a pneumothorax, to prevent pneumothorax if the chest tube is inadvertently disconnected from the drainage system, you can create a temporary water seal by placing the tubes open end in a. Mark the depth of the tube using a felt-tip marker and continually monitor during transport. If a drainage unit is used, be sure to keep it below the level of the chest. (Always use an appropriate chest drain system. Chest tubes should never be attached directly to wall or portable suction continue to drain. The next time the nurse visits, tell the visiting nurse that the unit fell over. • Keep the Pleur-evac Unit below chest level to promote drainage by gravity. Make sure the unit is below chest level when you are sitting, standing, lying down and walking. • Always keep 2 orange clamps close by. If any tube becomes disconnected Tube thoracostomy is the insertion of a tube (chest tube) into the pleural cavity to drain air, blood, bile, pus, or other fluids. Whether the accumulation of air or fluid is the result of rapid traumatic filling with air or blood or an insidious malignant exudative fluid, placement of a chest tube allows for continuous, large volume drainage.