Chest Tubes, Artificial Airways, Tracheostomy Care & Home Oxygen Safety - Fundamentals | @LevelUpRN

Introduction

This tutorial provides a comprehensive overview of chest tubes, artificial airways, tracheostomy care, and home oxygen safety. Whether you are a nursing student or a practicing nurse, understanding these fundamental concepts is essential for patient care. This guide will walk you through the key points and best practices to ensure safety and efficacy in these areas.

Chapter 1: Chest Tubes

Understanding Chest Tubes

• Purpose: Chest tubes are used to drain air, fluid, or blood from the pleural space.
• Components: Familiarize yourself with the drainage system, which includes:
  • Drainage Collection Chamber: Collects fluid or air.
  • Water Seal Chamber: Provides an airtight seal.
  • Suction Control Chamber: Controls suction if connected.

Monitoring Drainage

• Report drainage greater than 100 milliliters per hour to the provider.
• Tidaling: Normal movement of fluid in the water seal chamber with respirations. Continuous bubbling indicates a leak.

Nursing Care for Chest Tubes

• If continuous bubbling is observed, restore the seal by placing the tube end in sterile water or saline and contact the provider.
• Always keep the collection device flat and below the patient’s chest to accurately track output.
• Never clamp the tube unless ordered, and avoid manually moving fluid towards the collection device.

Chapter 2: Artificial Airways

Types of Artificial Airways

• Oropharyngeal and Nasopharyngeal Airways: Provide a pathway for air but do not secure the airway.
• Endotracheal Tube (ET Tube): A true artificial airway inserted into the trachea to deliver oxygen directly to the lungs.
• Tracheostomy Tube: Surgically created opening in the neck for long-term ventilation.

Best Practices for Insertion

• Use water-soluble lubricant for nasal insertions.
• Insert the oral adjunct upside down and twist into position to keep the tongue in place.

Chapter 3: Tracheostomy Care

Cleaning and Maintenance

• Always clean from the stoma outward to avoid introducing bacteria.
• Use sterile technique in the hospital; home care may involve clean technique.
• When using split gauze, ensure it is pre-split to avoid introducing lint.

Chapter 4: Home Oxygen Safety

Key Safety Practices

• No Smoking: Post "No Smoking" signs inside and outside the home.
• Tank Positioning: Keep oxygen tanks upright and securely housed.
• Lubricants: Use only water-based lubricants.
• Clothing: Wear cotton clothing to prevent sparks; avoid synthetic fabrics.
• Electrical Safety: Check for frayed cords and repair or replace them to avoid fire hazards.

Conclusion

In summary, understanding chest tubes, artificial airways, tracheostomy care, and home oxygen safety is crucial for providing safe and effective patient care. Always prioritize patient safety and adhere to established protocols. For further learning, consider reviewing nursing resources and practicing hands-on skills in clinical settings. Happy studying!