12/22/2023 0 Comments Pleur evac setup![]() ![]() If the bubbling fluctuates with respiration (i.e. If you cannot see or hear any obvious leaks at the site, the leak is from the lung. Make sure the catheter eyelets have not pulled out beyond the chest wall. Identify the source of the air leak: (a) check and tighten connections, (b) test the tubing for leaks**, (c) if a leak exists, it may be at the insertion site, remove the chest tube dressing and inspect the site. CONTINUOUS OR INTERMITTENT BUBBLING? Note the pattern of the bubbling. CAUTION: If suction is not operative, or if operating on gravity drainage, depressing the high negativity relief valve can reduce negative pressure within the collection chamber to zero (atmosphere) with the resulting possibility of a pneumothorax. WATER RISING IN SMALL ARM OF THE WATER SEAL/AIR LEAK METER? Depress the manual high negativity relief valve until the water level reaches the desired level. (Example: -20 suction plus -10 water seal = -30 cm H 2 O patient negativity.) The orange float must appear in the suction indicator window, indicating suction is operative, in order to determine the negative pressure in the chest cavity. WITH SUCTION, add the reading from the suction dial setting to the reading of the water seal pressure scale. PRESSURE SCALE (TO DETERMINE NEGATIVE PRESSURE IN PATIENT’S CHEST CAVITY): WITHOUT SUCTION, the pressure in the chest cavity is read directly by the fluid level in the calibrated water seal pressure scale. To withdraw water, a syringe with a 1-1/2” 18 or higher gauge needle angled downward through the Self-Sealing Diaphragm on the front of the chamber,may be used. Water may need to be withdrawn if chamber is overfilled. ![]() Add as needed through short suction tube. Water may need to be added due to evaporation. LEVEL OF WATER IN WATER SEAL CHAMBER The water level should be at 2 cm. To keep the tubes patent, or to dislodge clots, gently milk the patient tube according to hospital policy. This can lead to life-threatening cardiac tamponade. HAS THE DRAINAGE STOPPED SUDDENLY? A sudden (not gradual) cessation of drainage in the patient with mediastinal tubes can be caused by accumulated clotted blood occluding the tube. Stripping with the clamps closed can result in the build-up of excessive postive pressure. Stripping the patient tube must be done with the patient tubing clamp open.In the event of a patient air leak, clamping the chest tubes could lead to a tension pneumothorax. Chest tubes should not be clamped except when changing the Pleur-Evac Unit.The collected contents of the Pleur-Evac unit should not be used for reinfusion.FULL COLLECTION CHAMBER When drainage reaches 2500cc, the unit is filled to capacity. “Spillover” from one section to the next should also be noted after the Pleur-evac unit has been moved or handled. (This may be attributed to surface tension “build-up”.) The actual volume of the previous section(s) should therefore be checked if accuracy of the total reading is critical. Figure 2 Figure 3 NURSING CONSIDERATIONS AND TROUBLESHOOTING* ColleCtion Chamber water seal Chamber air leak meter Dry suCtion Control Chamber MEASUREMENT OF DRAINAGE When reading collection chamber calibrations, please note there may be a decrease in original volume of first section after fluids spill over into the next. DO NOT : Clamp patient tubing during transport (patient has protection of water seal). AVOID: Dependent loops in patient tubing. CAUTION: Keep Pleur-evac ® Unit below patient’s chest level at all times. Note: Source suction must be capable of delivering a minimum of 16 liters per minute (LPM) air flow. Figure 3 shows the suction control dial set at -40 cm of water and the float in the indicator window. The position of the suction control dial determines the approximate amount of suction imposed regardless of the amount of source suction - as long as the orange float appears in the indicator window. Suction Source Turn on the suction and increase it until the orange float appears in the suction indicator window. To adjust the suction control setting, rotate the dial until the red stripe appears in the semi-circular window at the prescribed suction level line and clicks into place. Suction Control Suction control dial is preset at -20 cm H 2 O (Figure 2). Connect to Suction Source Connect the suction source to the suction port. Connect Patient Tube Connect long patient tube from the collection chamber to the patient’s thoracic catheter. Once filled, the water will turn blue 2.The bottle contains enough water to fill the water seal chamber. Attach the exposed tip to the connector on the suction port.To open, twist and break the bottle seal. A sterile water bottle is provided to facilitate filling. ![]() If suction is not required, follow steps 1 and 2. OTHER A-6000 SERIES AUTOTRANSFUSION BAGS SETUP INSTRUCTIONS: If suction is prescribed, follow steps 1 through 5.
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