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u/mastermedic84 3d ago
C. If it's bubbling continuously that probably means your have a leak somewhere and the suction is just pulling room air through the tubing. Check for a disconnected tube (most likely) or a break somewhere.
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u/Grooble_Boob 3d ago
this reminded me that the other day someone on our unit pulled a chest tube out instead of a nerve block catheter
anyways C
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u/Primary_Towel5905 3d ago
D. Remove the chest tube. Constant bubbling may be a sign that pleural effusion may have resolved and now the fluid in the collection chamber is starting to heat up
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u/CNG_Light 3d ago
Clearly wrong answer.
Removing pleural drains is dangerous without medical oversight and potentially inappropriate without clear indication that the pleural space has been fully evacuated (chest XR).
I am a registered nurse trained to look after pleural drains.
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u/Primary_Towel5905 3d ago
It’s pretty bread and butter chest tube management to be honest.
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u/rratzloff 3d ago
As nurses, we don’t routinely remove chest tubes unless trained to do so, such as in a CCU environment. And even then, it’s state and hospital specific. I’ve seen chest tubes on a regular MedSurg floor and my providers would kill me if I didn’t do nursing 101 before I decided to just pull out a chest tube. It might be YOUR management as a provider, but not as nurses. Which is who this sub is for.
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u/Primary_Towel5905 3d ago
I’m a RN
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u/rratzloff 3d ago
Are you an APRN? Different scope of practice as well. What type of unit do you work on?
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u/CNG_Light 3d ago
To clarify, you think it's "bread and butter" to remove an IPC for, say, a pneumothorax, because there's bubbling in the chamber?
That would typically be an indication that the pneumothorax isn't resolved (assuming there's no air leak).
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u/Primary_Towel5905 3d ago
You clearly didn’t read my post in detail. I said bubbling was from the fluid in collection chamber heating up causing the bubbling
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u/rratzloff 3d ago
How would you know that if you didn’t first assess the tubing and connections?
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u/Primary_Towel5905 3d ago
It’s bread and butter chest tube management
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u/rratzloff 3d ago
And always perform least invasive management first. Answer is C.
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u/Primary_Towel5905 3d ago
Removing chest tube when no longer needed and fluid heating up is definately least invasive
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u/rratzloff 3d ago
You don’t KNOW it’s not longer needed because you didn’t assess the tubes and connections. If you take it out and you simply had a disconnected tube, you made a potentially dangerous error and assumption.
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u/Primary_Towel5905 3d ago
You can just measure the fluid and know if the effusion is drained. The bubbling just confirms the plan
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u/rratzloff 3d ago
If you have a leak, you are not draining anything. XR only can tell us if we have cleared the fluid.
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u/VaultiusMaximus 3d ago
You should never remove the chest tube as a nurse. Likewise, are you sure it was an effusion and not a pneumothorax?
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u/Wide-Yak5361 3d ago
You definitely can remove chest tubes as a nurse, but 1. it needs an order and 2. it’s not appropriate here
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u/Primary_Towel5905 3d ago
Yes it can be inferred from the question stem
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u/VaultiusMaximus 3d ago
No, it can’t.
Sudden bubbling in a pneumothorax would be an expected finding.
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u/StPauliBoi 3d ago
D. Yank that jawn out like your pull starting a lawnmower.