Here is a simple algorithm for our management of chest tubes.
1. Chest tube is placed. Connect to 20 cm of suction.
2. CXR to confirm proper placement and resolution of PTX/HTX
3. Daily CXR
4. After 24 hours of suction, evaluate for presence of air leak.
5. If no air leak or residual PTX, can place on Water Seal (regardless of output)
6. Repeat CXR to ensure that lung is still inflated
7. Once output is less than 100 ml per day and the chest tube has been on water seal for 24h, it may be removed.
8. Removal is a 2-person job! Vaseline gauze dressing to remain in place for 48 hours.
9. Repeat CXR to rule out post-pull PTX
1. Chest tube is placed. Connect to 20 cm of suction.
2. CXR to confirm proper placement and resolution of PTX/HTX
3. Daily CXR
4. After 24 hours of suction, evaluate for presence of air leak.
5. If no air leak or residual PTX, can place on Water Seal (regardless of output)
6. Repeat CXR to ensure that lung is still inflated
7. Once output is less than 100 ml per day and the chest tube has been on water seal for 24h, it may be removed.
8. Removal is a 2-person job! Vaseline gauze dressing to remain in place for 48 hours.
9. Repeat CXR to rule out post-pull PTX
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