Chest tube flush and aspirate?

Pt has a small-bore chest tube. Pt has empeyma and they had aspirated 30cc fluid when it was inserted. Doctor's notes says to flush 10cc normal saline and aspirate q shift. Has anyone done this? Giving report to another nurse when transferring the pt said never to flush a chest tube... I'm a new nurse and if I remember correctly I did this 2 months ago on another pt. Maybe this is new research. Idk I'm confused.
It's not something you do frequently, but if there's a lot of clots coming out, it's generally preferable to keep the tube patent and draining.Wait til the day you're asked to instill TPN through a chest tube. That will really freak people out! (It sure did me the first time I saw it, was not sure I should be trusting that surgical resident. )

Quote from woohIt's not something you do frequently, but if there's a lot of clots coming out, it's generally preferable to keep the tube patent and draining.Wait til the day you're asked to instill TPN through a chest tube. That will really freak people out! (It sure did me the first time I saw it, was not sure I should be trusting that surgical resident. )

Quote from Perpetual StudentTPN or did you maybe mean TPA? I'm really struggling to figure out how TPN would do anything other than lead to one heckuvan infection

Oh, sorry OP, forgot to answer your question. I've never done it, but it is something that is safe and reasonable to do. Just be careful to maintain sterility.

Check your BON regs.In some states, nurses are not permitted to inject anything into a chest tube.And as with all new skills, if it is permissible to do, Check the P&P for your facility and/or have a nurse that has done the procedure, assist you the first time.

Quote from woohIt's not something you do frequently, but if there's a lot of clots coming out, it's generally preferable to keep the tube patent and draining.Wait til the day you're asked to instill TPN through a chest tube. That will really freak people out! (It sure did me the first time I saw it, was not sure I should be trusting that surgical resident. )

We have to do this sometimes. We use a lopez valve (or stop cock as you may know it) to do the flush aspirate thing. It's because the pigtails are so small that they get clogged up easily. We have also done insane things like blood patches to stop air leaks, instilling doxycycline through chest tubes and have the patient roll around a lot so hey get a pluerodesis effect. And we had a patient once who had a pneumonectomy, and we had to instill vancomycin into the lung cavity and then drain it through a lower chest tube.Weird huh?

Quote from tcvnurseWe have to do this sometimes. We use a lopez valve (or stop cock as you may know it) to do the flush aspirate thing. It's because the pigtails are so small that they get clogged up easily. We have also done insane things like blood patches to stop air leaks, instilling doxycycline through chest tubes and have the patient roll around a lot so hey get a pluerodesis effect. And we had a patient once who had a pneumonectomy, and we had to instill vancomycin into the lung cavity and then drain it through a lower chest tube.Weird huh?

If you are permitted to do it at your hospital, there should be a policy/procedure in your manual/online. Check that before doing it!

I think they did mean TPA, not TPN.(?) Where I worked before it was done farily frequently, but always by an NP/physician.I have flushed small bore chest tubes with a small amount of NS--always keep very close track of how much you instill vs. how much you aspirate. Oh, and make sure its sterile...no sink water! :uhoh21:

there are chest tubes and there are chest tubes. if you know why it's in there, where, precisely, it is placed, and the precautions you need to take to prevent pneumothorax, it's sometimes ok to irrigate one. empyema is a classic example-- sometimes these people even have open chest wounds that won't close due to the infection and poor nutritional status, and there is no pleural integrity. sometimes the infection is outside the pleura, and that may require different precautions. instilling regular doses of antibiotics, with precise i&o, isn't that unusual. i've seen the pleurodesis thing work like a charm to create enough of an inflammatory effect that the parietal pleura adheres to the visceral pleura (sclerosis) and thus removes the space between them that can fill up with an effusion. no effusion collection = no space-occupying stuff to cause lung collapse.you would not be disconnecting a chest tube on a recent postop thoracotomy/open heart/spontaneous pneumothorax, etc if you thought it was occluded. you would call for a stat physician eval and anticipate removal and changing, more than likely.

Just want to put in my two cents. About 15 years ago I had a patient in ICU with a chest tube we would flush. I know it was not normal saline, and I don't think it was an antibiotic. I may be wrong but I think the purpose was to help the pleura adhere to the chest wall? (I know it wasn't super glue, ha ha.)