Chest Tube Insertion and Care
A chest tube is a plastic tube that drains air or extra liquid from the space between your lungs and chest wall. This area is called the pleural (PLOO–ral) space. It is normal for a thin layer of fluid to be present in this space. If the space fills with too much fluid, or with air, the lung can collapse. When a chest tube is in place, the air or extra fluid drains out of the pleural space through the tube. When the air or excess fluid is gone, your lung can expand. You will be able to breathe better.
Some of the problems that can cause air or too much fluid in the pleural space are:
- Trauma or injury
- Chest surgery. If you have chest surgery and need a chest tube, it will be put in during your surgery. With some kinds of surgery, more than one tube may be placed in your chest.
- Air leaking into the chest cavity from inside the lung. This is called pneumothorax (NEW–moh–THOR–aks). Some lung diseases can cause this problem.
- Fluid leaking into the chest cavity. This is called a pleural effusion (ee–FYOO–zhun). Problems that can cause this condition include:
- A lung infection called an abscess (AB–sess)
- A buildup of pus in the chest cavity, called empyema (EM–pye–EE–muh)
- Heart failure
- A blood clot in the lung. This is called a pulmonary (PULL–muh–NEH–ree) embolism (EM–buh–lizm)
Other problems also can cause fluid to build up in your chest cavity.
A chest tube can be put in while you are in your hospital room. Some patients receive a chest tube in the operating room. If a chest x-ray shows that there is air or fluid in your pleural space, you may have a chest tube inserted while you are in the radiology department.
Before Chest Tube Insertion
You may be given medicine to help you relax. You will be sitting up or lying on your side. One arm will be raised over your head. The area where the tube is to be placed will be cleaned. You will receive a shot to numb the area. This may cause a burning feeling at first. This will go away as the area becomes numb.
During Chest Tube Insertion
Your doctor will make a small cut and put in the chest tube. He or she will make a small stitch to hold the tube in place. A bandage will be placed over the tube at the insertion site. The tube will be attached to a drainage system.
After Chest Tube Insertion
You will have chest x-rays while the tube is in place. The x-rays will help the doctor know when all the air or extra fluid is out of your pleural space. The x-ray will also show how well your lung is expanding.
Your chest tube will be connected to a long, flexible tube. This tube will be attached to a drainage container at the side of your bed. The container may already be partly filled with sterile water.
You may need suction to help drain your pleural space. If this is the case, your chest tube may be connected to suction coming from the wall in your room. You may notice a bubbling sound from the suction.
Some people do not need suction for their chest tube. If this is the case, your chest tube will be connected only to a drainage system. Drainage will occur by gravity.
When to Get Help
If you have any of the following problems, tell your nurse right away.
- A sudden problem with breathing
- A breathing problem that is getting worse
- The chest tube comes out
- The tube becomes disconnected from the drainage system
- The drainage system gets knocked over
Tell your nurse if you have pain or discomfort. Pain medicine will most likely be available.
- Most drainage containers must always remain below the level of your chest.
- Most drainage systems should remain upright. If it is not set upright, the tube may not drain or the air seal could be broken. If knocked over, immediately stand it up and call for the nurse to check it.
- Take slow, deep breaths. This helps expand your lungs. Your doctor or nurse will teach you how to use an incentive spirometer (speh–RAHM–eh–ter).
- Do not pinch or tug on the tubing of the drainage system. The extra fluid or air must be able to drain from your chest so that your lung can expand.
- Ask your nurse about the things you are allowed to do. Depending on your drainage system, you may be able to sit in a chair, walk, and go to the bathroom. Ask for help before doing these activities.
Chest Tube Removal
You will probably be in bed in your hospital room when the chest tube is taken out. Your doctor will tell you how to breathe as the tube is being removed. After the tube is taken out, you will have a sealed bandage over the insertion site. The bandage will stay in place for a few days. Your doctor will tell you when the bandage can be taken off. You will receive instructions on how to care for this area.
Leaving the Hospital with a Chest Tube
Some patients may need to leave the hospital with the chest tube still in place. Before you leave the hospital, your doctor or nurse will teach you how to care for the chest tube. Ask your nurse about home care services to help you take care of your chest tube.
Ask your doctor if you will need any additional care or instructions after you leave the hospital.