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

ACoRN © 2005ACoRN © 2005

Pneumothorax Pneumothorax DrainageDrainage

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

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

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

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

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

Needle aspirationNeedle aspiration

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

Chest tube insertionChest tube insertion

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

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?)

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

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

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

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

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

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

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

Insertion of chest tubeInsertion of chest tube

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

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

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

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

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

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

ACoRN © 2005ACoRN © 2005

Chest Tube Chest Tube Drainage SystemsDrainage Systems

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

Flutter valveFlutter valve

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

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

Pleur-evacPleur-evac

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

Vacuum regulatorsVacuum regulators

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

Questions?Questions?