5 things to note when nursing closed chest drainage after lung cancer surgery

After lung resection, a drainage tube is often placed in the upper and lower parts of the lungs. The upper tube is mainly used to exhaust air, and the lower tube is mainly used to drain fluid, in order to accelerate the re-expansion of the lungs and eliminate residual cavities. After surgery, the lower drainage tube is connected to the long glass tube of the chest closed drainage bottle. The day after the upper tube surgery, the medical staff will connect the negative pressure suction, and the pressure regulating tube should be kept 12 to 16 cm below the water surface. The chest closed drainage is inserted 2 to 3 cm above the water surface. The following precautions should be taken during the nursing process:

1. The drainage tube should not be raised above the level of the chest cavity, so that the liquid in the bottle will be sucked back into the chest cavity.

2. The drainage rubber tube should not be too long or droop at an angle, which will affect the discharge of liquid.

3. Avoid compression or bending of the drainage tube, and squeeze it frequently to prevent it from being blocked by blood clots or cellulose.

4. Observe the fluctuation of water column at any time

The general amplitude is 4 to 6 cm. If there is no water column, check whether the drainage device is leaking or the drainage tube is dislocated into the chest wall. If the water column does not fluctuate, the drainage tube may be blocked or twisted. If the water column fluctuates too much, the upper respiratory tract may be blocked. If the water column does not fluctuate much and rises excessively, it may be atelectasis, which should be corrected in time.

5. Observe the nature and amount of drainage fluid

The first day after surgery should not exceed 500ml, and gradually decrease on the second and third days after surgery. If it exceeds 100ml per hour in a short period of time, and the blood color is too dark or accompanied by blood clots, and the hemoglobin in the drainage fluid exceeds 5g, it indicates internal bleeding and requires another thoracotomy to stop bleeding. Generally, 36 to 48 hours after surgery, if the lungs have re-expanded and the exudate has stopped, the drainage tube can be removed.