acorn © 2005 pneumothorax drainage. nov 2007 acorn © 2005-07 acute deterioration is commonacute...

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ACoRN © 2005 ACoRN © 2005 Pneumothorax Pneumothorax Drainage Drainage

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Page 1: ACoRN © 2005 Pneumothorax Drainage. Nov 2007 ACoRN © 2005-07 Acute deterioration is commonAcute deterioration is common Deviation of apex may be detectable

ACoRN © 2005ACoRN © 2005

Pneumothorax Pneumothorax DrainageDrainage

Page 2: ACoRN © 2005 Pneumothorax Drainage. Nov 2007 ACoRN © 2005-07 Acute deterioration is commonAcute deterioration is common Deviation of apex may be detectable

Nov 2007Nov 2007 ACoRN © 2005-07ACoRN © 2005-07

• Acute deterioration is commonAcute deterioration is common• Deviation of apex may be detectable if Deviation of apex may be detectable if

large pneumothorax large pneumothorax

• Breath sounds may be unequalBreath sounds may be unequal• Asymmetry of chest rareAsymmetry of chest rare• Tracheal deviation cannot be clinically Tracheal deviation cannot be clinically

noted (the neck is too short)noted (the neck is too short)

Pneumothorax: Clinical signs Pneumothorax: Clinical signs

Page 3: ACoRN © 2005 Pneumothorax Drainage. Nov 2007 ACoRN © 2005-07 Acute deterioration is commonAcute deterioration is common Deviation of apex may be detectable

Nov 2007Nov 2007 ACoRN © 2005-07ACoRN © 2005-07

Chest transilluminationChest transillumination

• To attempt to detect a pneumothorax at To attempt to detect a pneumothorax at the bedside while awaiting for a chest the bedside while awaiting for a chest radiographradiograph

• AfterAfter ruling out mechanical causes such ruling out mechanical causes such as equipment malfunction, obstructed as equipment malfunction, obstructed airway or ETT, or displaced ETTairway or ETT, or displaced ETT

Page 4: ACoRN © 2005 Pneumothorax Drainage. Nov 2007 ACoRN © 2005-07 Acute deterioration is commonAcute deterioration is common Deviation of apex may be detectable

Nov 2007Nov 2007 ACoRN © 2005-07ACoRN © 2005-07

Page 5: ACoRN © 2005 Pneumothorax Drainage. Nov 2007 ACoRN © 2005-07 Acute deterioration is commonAcute deterioration is common Deviation of apex may be detectable

Nov 2007Nov 2007 ACoRN © 2005-07ACoRN © 2005-07

• Needle aspirationNeedle aspiration– Emergency onlyEmergency only– Can be diagnostic if no X-ray immediately Can be diagnostic if no X-ray immediately

availableavailable– Not for permanent drainageNot for permanent drainage

• Chest tube placement Chest tube placement – Infrequently used skillInfrequently used skill– May be done more safely if chest has not May be done more safely if chest has not

been previously needled been previously needled

Pneumothorax drainagePneumothorax drainage

Page 6: ACoRN © 2005 Pneumothorax Drainage. Nov 2007 ACoRN © 2005-07 Acute deterioration is commonAcute deterioration is common Deviation of apex may be detectable

Nov 2007Nov 2007 ACoRN © 2005-07ACoRN © 2005-07

Needle aspirationNeedle aspiration

Page 7: ACoRN © 2005 Pneumothorax Drainage. Nov 2007 ACoRN © 2005-07 Acute deterioration is commonAcute deterioration is common Deviation of apex may be detectable

Nov 2007Nov 2007 ACoRN © 2005-07ACoRN © 2005-07

Chest tube insertionChest tube insertion

Page 8: ACoRN © 2005 Pneumothorax Drainage. Nov 2007 ACoRN © 2005-07 Acute deterioration is commonAcute deterioration is common Deviation of apex may be detectable

Nov 2007Nov 2007 ACoRN © 2005-07ACoRN © 2005-07

Page 9: ACoRN © 2005 Pneumothorax Drainage. Nov 2007 ACoRN © 2005-07 Acute deterioration is commonAcute deterioration is common Deviation of apex may be detectable

Nov 2007Nov 2007 ACoRN © 2005-07ACoRN © 2005-07

• Before Before preparing preparing your your equipment, equipment, what should what should you consider?you consider?

• HINT (does HINT (does the procedure the procedure hurt?)hurt?)

Page 10: ACoRN © 2005 Pneumothorax Drainage. Nov 2007 ACoRN © 2005-07 Acute deterioration is commonAcute deterioration is common Deviation of apex may be detectable

Nov 2007Nov 2007 ACoRN © 2005-07ACoRN © 2005-07

Page 11: ACoRN © 2005 Pneumothorax Drainage. Nov 2007 ACoRN © 2005-07 Acute deterioration is commonAcute deterioration is common Deviation of apex may be detectable

Nov 2007Nov 2007 ACoRN © 2005-07ACoRN © 2005-07

Page 12: ACoRN © 2005 Pneumothorax Drainage. Nov 2007 ACoRN © 2005-07 Acute deterioration is commonAcute deterioration is common Deviation of apex may be detectable

Nov 2007Nov 2007 ACoRN © 2005-07ACoRN © 2005-07

Page 13: ACoRN © 2005 Pneumothorax Drainage. Nov 2007 ACoRN © 2005-07 Acute deterioration is commonAcute deterioration is common Deviation of apex may be detectable

Nov 2007Nov 2007 ACoRN © 2005-07ACoRN © 2005-07

Page 14: ACoRN © 2005 Pneumothorax Drainage. Nov 2007 ACoRN © 2005-07 Acute deterioration is commonAcute deterioration is common Deviation of apex may be detectable

Nov 2007Nov 2007 ACoRN © 2005-07ACoRN © 2005-07

Page 15: ACoRN © 2005 Pneumothorax Drainage. Nov 2007 ACoRN © 2005-07 Acute deterioration is commonAcute deterioration is common Deviation of apex may be detectable

Nov 2007Nov 2007 ACoRN © 2005-07ACoRN © 2005-07

Page 16: ACoRN © 2005 Pneumothorax Drainage. Nov 2007 ACoRN © 2005-07 Acute deterioration is commonAcute deterioration is common Deviation of apex may be detectable

Nov 2007Nov 2007 ACoRN © 2005-07ACoRN © 2005-07

Insertion of chest tubeInsertion of chest tube

Page 17: ACoRN © 2005 Pneumothorax Drainage. Nov 2007 ACoRN © 2005-07 Acute deterioration is commonAcute deterioration is common Deviation of apex may be detectable

Nov 2007Nov 2007 ACoRN © 2005-07ACoRN © 2005-07

Page 18: ACoRN © 2005 Pneumothorax Drainage. Nov 2007 ACoRN © 2005-07 Acute deterioration is commonAcute deterioration is common Deviation of apex may be detectable

Nov 2007Nov 2007 ACoRN © 2005-07ACoRN © 2005-07

Page 19: ACoRN © 2005 Pneumothorax Drainage. Nov 2007 ACoRN © 2005-07 Acute deterioration is commonAcute deterioration is common Deviation of apex may be detectable

Nov 2007Nov 2007 ACoRN © 2005-07ACoRN © 2005-07

Page 20: ACoRN © 2005 Pneumothorax Drainage. Nov 2007 ACoRN © 2005-07 Acute deterioration is commonAcute deterioration is common Deviation of apex may be detectable

Nov 2007Nov 2007 ACoRN © 2005-07ACoRN © 2005-07

Page 21: ACoRN © 2005 Pneumothorax Drainage. Nov 2007 ACoRN © 2005-07 Acute deterioration is commonAcute deterioration is common Deviation of apex may be detectable

Nov 2007Nov 2007 ACoRN © 2005-07ACoRN © 2005-07

Page 22: ACoRN © 2005 Pneumothorax Drainage. Nov 2007 ACoRN © 2005-07 Acute deterioration is commonAcute deterioration is common Deviation of apex may be detectable

Nov 2007Nov 2007 ACoRN © 2005-07ACoRN © 2005-07

Page 23: ACoRN © 2005 Pneumothorax Drainage. Nov 2007 ACoRN © 2005-07 Acute deterioration is commonAcute deterioration is common Deviation of apex may be detectable

ACoRN © 2005ACoRN © 2005

Chest Tube Chest Tube Drainage SystemsDrainage Systems

Page 24: ACoRN © 2005 Pneumothorax Drainage. Nov 2007 ACoRN © 2005-07 Acute deterioration is commonAcute deterioration is common Deviation of apex may be detectable

Nov 2007Nov 2007 ACoRN © 2005-07ACoRN © 2005-07

Flutter valveFlutter valve

Page 25: ACoRN © 2005 Pneumothorax Drainage. Nov 2007 ACoRN © 2005-07 Acute deterioration is commonAcute deterioration is common Deviation of apex may be detectable

Nov 2007Nov 2007 ACoRN © 2005-07ACoRN © 2005-07

Underwater drainageUnderwater drainage

Collection Collection chamberchamber

Suction Suction pressurepressure

Underwater Underwater sealseal

Patient endPatient end

Wall suctionWall suction

Page 26: ACoRN © 2005 Pneumothorax Drainage. Nov 2007 ACoRN © 2005-07 Acute deterioration is commonAcute deterioration is common Deviation of apex may be detectable

Nov 2007Nov 2007 ACoRN © 2005-07ACoRN © 2005-07

Pleur-evacPleur-evac

Page 27: ACoRN © 2005 Pneumothorax Drainage. Nov 2007 ACoRN © 2005-07 Acute deterioration is commonAcute deterioration is common Deviation of apex may be detectable

Nov 2007Nov 2007 ACoRN © 2005-07ACoRN © 2005-07

Vacuum regulatorsVacuum regulators

Page 28: ACoRN © 2005 Pneumothorax Drainage. Nov 2007 ACoRN © 2005-07 Acute deterioration is commonAcute deterioration is common Deviation of apex may be detectable

Nov 2007Nov 2007 ACoRN © 2005-07ACoRN © 2005-07

Questions?Questions?