Understanding Nursing Procedure # 10: Chest Tube Removal

Chest tube removal is a necessary nursing procedure that can make even seasoned nurses rather nervous--and understandably so. There are many ways chest tube removal could go wrong, which is why proper nursing procedure is of the utmost importance.

Chest Tube Removal: The Proper Nursing Procedure

You learned about chest tube removal in nursing school and now it's time to brush up on those skills. Think carefully about each step:

  1. Consult with the medical team to make certain the chest tube is ready for removal.
  2. Talk to the patient about what you will do, and offer pain relief medication to ease their anxiety.
  3. Hold the chest tube firmly in place while you gently remove the sutures around it.
  4. Ask the patient to draw in a deep breath, but then try to blow it out while closing off their nose and mouth. Practice the Valsalva maneuver a few times so they understand how it works.
  5. As soon as the Kelly clamp is on the tube, tell the patient to perform the Valsalva maneuver.
  6. Gently but quickly pull the tube out of the chest.
  7. Immediately press Vaseline gauze against the area.
  8. Tape down the gauze, covering the entire area to ensure the wound remains airtight.
  9. Continue to assess respiratory status and closely monitor the patient for any signs of complications.
  10. Make sure the patient has a final chest x-ray after the procedure is completed.

Tips You Might Have Missed in Nursing School

The proper nursing procedure for chest tube removal is rather straightforward, but there are a few tips and tricks to make it easier. Keep these hints in mind when you need to remove a chest tube:

  • Be reassuring. The insertion of a chest tube hurts, but the removal should be only a minor discomfort. Explain this to the patient and answer any questions they might have.
  • Use disposable pads. Don't forget to put a disposable pad underneath the patient's affected side. This not only protects the bed, but allows you to roll all the used supplies up neatly before disposing of them properly.
  • Watch for purse-string stitches. If there is a purse-string stitch at the incision site, be careful not to cut it.

Successful Chest Tube Removal

If you got your online nursing degree, you might have learned quite a bit about chest tube removal but rarely done the procedure yourself. Now is the time to brush up on what you know. Take the time to learn all you can about chest tube removal, and you should be able to project a reassuring confidence to a very nervous patient.



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