Question

Please help answer these question

1. List 3 risk factors for patients who are at risk for sepsis or septic shock

2. Differentiate between water seal and dry suction chest tube therapy

3. Describe one emergency intervention related to chest tube therapy.

4. Explain 3 safe interventions related to chest tube therapy

Answer 1

1. Answer:

Following are the list of 3 risk factor for patients who are at risk for sepsis or septic shock.

• A. The people with chronic conditions like:- a) Diabetes, b) Cancer, c) Kidney or Lung disease.
• B. Immune compromised people, patient with severe or high grade burnt.
• C. Pregnant women, Patients with catheters, invasive devices, operative procedures, prolonged hospitalization.

2. Answer:

• Differences between Water seal and dry suction chest tube therapy

  Water Seal Chest Tube	Dry Suction Chest Tube
  Only limited suction pressure can be achieved	Higher suction pressure can be achieved
  Suction pressure can be regulated by the height of a Water column.	Suction pressure can be regulated by air flow
  Commonly preferred Suction can be set up to -20 cm H2O	Suction can be set at different ranges, -10, -15, -20, -30 or -40
  Lower level of suction recommended for child, Infant and elderly with friable lung tissue.	Higher level of suction recommended for the patient with: Empyema, large leak of pressure from the lung, viscous pleural effusion, reduction in pulmonary compliance
  Excessive source suction couses loud air bubbling and decreased patient and care taker compliance (excessive noisy).	No such noise however due to its adavncement a bit more expensive, but more compliant than water seal.

3. Answer:

The emergency intervention related to chest tube therapy:

Basically chest tube is a sterile flexible plastic multi hole tube which is inserted through the chest wall and into the pleural space or mediastinum. It is also called Bulau drain or inter-costal catheter.

• Widely used in case of Pneumothorax, in case of pleural effusion, blood, chyle or pus, when empyema occurs in intrathoracic space.

4. Answer:

Followings are the three safe interventions related to chest tube therapy:

• A. A chest tube must be inserted at the sterile condition, bed side, in procedure room, or in a surgical suite.
• The removal, replacement and insertion should only be done by the expert (Physician).

• B. After initial insertion of a chest tube drainage system: The patient should be assessed each 15 to 1 hour interval. The frequency of the monitoring may be decided by the physician once the patient get stabilized. Patient vital signs, Consistency of fluid, colour, drainage amount, patient respiratory comforts etc are to be measured and recorded every 4 hour. The hospital policy and guidelines is to be strictly followed.

• C. Safety/Emergency equipment must always be ready for use and that to be the bedside of the patients. During transportation to the other departments following things must be ready:
• Two guarded clamps, sterile water, Vaseline gauze (Jelonet), 4 X 4 sterile dressing, Waterproof tape, etc.
• Never clamp a chest tube without a doctor's advice or a valid necessary reason.
• Restrict the entry and exit or over traffic in the ward.
• Asses chest tube insertion site to ensure dressing is sterile and intact.

Thank you and Good Luck