in this video I'm gonna give you four
vital things you need to know about
chest tubes in nursing school you've got
to know these things because they will
probably show up on your exam somewhere
and you definitely need to know them for
clinicals before we get started make
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so you do not miss out on any other
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I've got for you now let's dive in so
the first thing you must know about
chest tubes and nursing school is that
there is a difference between continuous
bubbling and intermittent bubbling in
the water seal chamber so chest tubes
can be used to help get air out from
around the lungs and the water seal
chamber is where all that air goes when
it leaves the body normally what happens
is as air leaves the pleural space
around the lungs it travels down into
the chest tube and into that water
sealed chamber and it causes a little
bit of bubbling in that water sealed
chamber this is intermittent bubbling
and that is totally fine just means the
chest tube is doing its job and it's
getting air out of the pleural space
from around the lungs however if there
is continuous bubbling in that water
sealed chamber that indicates that
there's an air leak somewhere because
the water sealed chamber will be
bubbling continuously like all the time
meaning that that air is constantly
passing through which is not normal for
when air is just trying to get out of
lungs so remember intermittent bubbling
is normal but continuous bubbling
indicates an air leak now the second
thing you must know when taking care of
chest tubes in nursing school is you
must keep the chest tube lower than the
chest now this allows it to drain
properly and maintain the proper
pressures I always like to equate it to
catheters it's kind of the same thing
always keep them lower than the level of
the patient because then this will allow
it to drain properly I remember my first
day
clinical on an ICU critical care floor
and I was so so nervous to help the
patient with their chest tube and you
know how when you're nervous you just
forget about everything does that happen
to you too that's what happened to me
and sometimes in nursing school my mind
would just go totally blank so
thankfully I had a really great nurse
that helped walk me through how to do
all of it and she reminded me to keep
that chest tube lower than the patient's
chest I was so careful with it tiptoeing
around as I moved it to where she wanted
it that was really really scary yes I
remember that it's always really scary
when you do new things and try new
things in nursing school and even
something that can seem super minor is
moving a chest tube it could be super
terrifying in nursing school I could not
be the only one that feels this way come
here with me and you totally get this
let me know down in the comments I'm
telling you I cannot be the only one who
feels this way now the third thing you
absolutely have to know about learning
chest tubes in nursing school is when to
call the doctor now of course this is
not an exhaustive list so always use
your amazing critical thinking skills
and always check the policies at your
facility but here are some times when
you would want to contact the doctor
you'll want to call the doctor if the
drainage suddenly increases it changes
in color to bright red if there's new
drainage on the dressing or if the
output is greater than 70 to 100
milliliters per hour if there's an air
leak in the system so like we talked
about before if you see that continuous
bubbling in the water seal chamber or if
a patient or if the patient has
breathing pattern changes or a change in
mental status or if the patient is
having signs or symptoms of shock so
those are all times when you would need
to contact the doctor keep all of those
things in mind as you take your nursing
school exams because sometimes they will
give you a question about what your
priority nursing action or first initial
action would be and then there are times
that you just there's not much you can
do like if their test you output is
greater than one
100 milliliters per hour so read your
nursing exam questions carefully and
decide when you can do something as the
nurse and when you would need to contact
the doctor now the fourth thing that you
need to know about when learning chest
tubes in nursing school is what to do in
an emergency right like if the chest
tube comes out before it's supposed to
and this is what a thing that nursing
schools just love to test you on so
you've got to pay attention here if the
chest tube comes out you will need to
take an occlusive dressing and put tape
around three sides of the dressing
leaving the fourth side open remember
that leave the fourth side open and put
it over the wound then call for help you
must must make sure that air can get out
of that pleural space that's why you
need to leave one of the sides open on
that occlusive dressing if you close all
of the sides that could cause a tension
pneumothorax where air gets trapped
inside and that pleural space around the
lungs and it puts pressure on blood
vessels and all the organs in the chest
so by taping only those three sides of
the dressing it allows some of that air
to escape and not get trapped so friend
the next time you take your nursing
school exam please remember these four
key points about chest tubes trust me
they will show up on your exams
eventually because nursing instructors
just love to test you on this stuff so
this video helped you out write love in
the comments below and make sure of
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got another awesome critical-care video
for you coming up next so stick around
and check it out to help you keep rockin
critical care in nursing school and go
become the nurse that God created only
you to be ahead I will see you over
there