Pneumothorax, Pleural Effusion and Chest Tubes

• Pleural effusion is when fluid is filled in the pleural sac. Signs include decreased lung sounds, dyspnea, cough, sharp chest pain, empyema (fever, night sweats and weight loss)
• Pneumothorax is when air is filled in the pleural cavity caused by puncture of the lungs leading to collapse
• Tension pneumothorax is an emergency that pushes pressure of the collapsed lung to the good lung
• Signs of pneumothorax include severe dyspnea, tachycardia, tracheal deviation, neck vein distention, hyper resonance, cyanosis, diaphoresis, hypotension, and tachypnea
• Emergency treatment of a pneumothorax is covering the wound with a dressing secured on three sides. For tension pneumothorax use needle decompression immediately.
• Steps of inserting a chest tube

  • Put water into water seal compartment to 2cm mark
  • Add water to suction to 20cm
  • Attach suction tubing to the drainage unit and wall suction
  • Place patient on left side with right arm raised
  • Keep HOB elevated
• If there is rapid bubbling in a chest tube, it means there is a leak
• When taking a chest tube out, put the end of the tube in sterile water and give pain treatment 60 minutes before taking it out