Risk Factors of Chest Drain Management
As discussed there are risks associated with the management and of chest drains. Practitioners need to be able to assess the risk and decide if the benefits outweigh the risks, to reduce risks where possible and to be able to troubleshoot when things do not go to plan. The table below is not exhaustive, but highlights some of the risks and problems.
Risks Associated with the on-going management of chest drains
| Risk | Cause | Practitioner's Action |
|
Chest drain displacement |
Poor skin suture technique Failure of patient to protect drain |
Make sure skin suture is knotted tightly enough to slightly indent drain. Tell the patient to protect the drain and to avoid pulling it. |
| Infection |
Poor Aseptic technique Re-inserting chest drain through initial incision Toxic Shock Syndrome |
Correct aseptic technique. Wash hands, sterile gloves, mask, and gown. Always make a fresh incision if a drain is to be re-inserted. Examine wound sites daily to check for signs of infection |
| Blockage of chest drain |
Small bore chest drains being used to drain either -Blood -Or pus Chest drain clamped inappropriately Chest drain kinked |
Use large bore chest drains in these circumstances Chest drains should NEVER be clamped except in very specific circumstances Regular monitoring of drains to makes sure that they are still working |
| Aspiration of chest bottle water into thoracic cavity | Lifting the underwater seal drainage system above the chest drain | The chest drain bottle should ALWAYS be kept below the level of the chest drain |
