Wet vs Dry Suction Chest Drainage System

Summary

This educational video script discusses wet and dry suction techniques for chest tubes, crucial for managing patients with hemothorax. It explains the importance of the drainage and water seal chambers, how to identify air leaks through bubbling, and the correct application of suction. The script also highlights the preference for dry suction due to its ease of use and the challenges of maintaining proper water levels and suction in wet suction systems.

Takeaways

• 😀 The video discusses the differences between wet and dry suction in chest tube management.
• 🔍 It explains how to identify which type of suction is being used by looking at the chambers of the chest tube system.
• 🩺 The presence of blood in the drainage chamber indicates a hemopneumothorax.
• 💧 The water seal chamber is crucial for allowing air to escape while preventing it from re-entering the pleural space.
• 🌀 Consistent bubbling in the water seal chamber suggests an air leak that needs further assessment.
• 📊 The grade of air leak can be determined by the pattern of bubbling in the water seal chamber.
• 🔄 The wet suction system has an additional suction chamber that requires water level maintenance to function properly.
• 📍 The dry suction system uses an orange bellow and a dial to set and indicate the level of suction.
• ⚠️ Incorrect suction levels can cause problems for the patient, so it's important to regulate it properly.
• 🛠️ The video mentions that the wet suction system can be more challenging to manage due to water evaporation and suction level regulation.
• 👩‍⚕️ The video is educational, aimed at nurses and healthcare providers, and encourages questions and comments for further clarification.

Q & A

What are the two types of suction discussed in the video?

The two types of suction discussed in the video are wet suction and dry suction.

What is the purpose of the drainage chamber in a chest tube system?

The drainage chamber collects fluids, such as blood in the case of a hemothorax, and helps determine the amount of drainage from the patient.

What does the presence of blood in the drainage chamber indicate?

The presence of blood in the drainage chamber indicates that the patient has a hemothorax.

What is the function of the water seal chamber in a chest tube system?

The water seal chamber allows air or fluids from the pleural space to exit while preventing air from re-entering. It also helps in detecting air leaks through bubbling.

How can you determine if there is an air leak in a patient's chest tube?

Consistent bubbling in the water seal chamber indicates an air leak, and the bubbling's frequency and pattern can help determine the severity of the leak.

What does the absence of the orange bellow in the suction control chamber mean?

The absence of the orange bellow in the suction control chamber means that the system is not connected to suction and is only at water seal.

What is the purpose of the suction chamber in a chest tube system?

The suction chamber in a chest tube system, found in wet suction systems, is used to apply suction and helps in managing the amount of suction being applied to the patient.

Why is it important to refill the water in the suction chamber to the 20 centimeter water line?

Refilling the water to the 20 centimeter water line ensures that the correct amount of suction is being applied, which is crucial for the patient's safety and effective treatment.

What should you do if the chest tube system has been tipped over?

If the chest tube system has been tipped over, it should be replaced with a new system to ensure accurate monitoring of drainage and prevent complications.

How can you tell if the suction is set correctly in a wet suction system?

In a wet suction system, the correct suction setting can be confirmed by the presence of the orange bellow floating up and staying at the 20 centimeter mark, indicating the appropriate suction level.

Why is it important to monitor the suction level in a chest tube system?

Monitoring the suction level is important to prevent complications such as insufficient drainage or damage to the patient's lung tissue due to excessive suction.

Outlines

00:00

🩺 Understanding Wet and Dry Suction in Chest Tubes

This paragraph introduces the topic of wet versus dry suction in chest tubes, explaining the importance of recognizing the differences between the two and how to manage them. The video script features two chest tubes, a Pleurovax system, and discusses the significance of the drainage chamber, water seal, and the presence of blood indicating a hemothorax. The water seal's role in allowing air to escape while preventing re-entry is highlighted, along with the method of identifying air leaks through bubbling in the water seal chamber. The script also explains the function of suction chambers and how to determine the correct level of suction, emphasizing the importance of proper suction management for patient safety.

05:03

🔬 Adjusting and Monitoring Suction Levels in Chest Tubes

The second paragraph delves into the technical aspects of adjusting suction levels in chest tubes, focusing on the challenges of regulating suction with a sensitive gauge. The script demonstrates the correct way to set suction levels using an orange bellow as an indicator, which should remain inflated at the set level of 20 centimeters. The importance of not having consistent bubbling in the water seal chamber, except for occasional bubbles indicating a resolving pneumothorax, is reiterated. The paragraph also addresses the expected bubbling in the suction chamber of a wet suction system and the use of a bellow in a dry suction system to confirm proper suction application. The video concludes by inviting viewers to ask questions and providing a brief musical outro.

Keywords

💡Wet Suction

Wet suction refers to a method of chest tube management where a water seal is used to prevent air from entering the pleural space while allowing air to escape. In the video, the nurse discusses the wet suction system, which includes a water seal chamber and a suction chamber. The presence of bubbling in the suction chamber indicates the application of suction and helps in monitoring the patient's condition.

💡Dry Suction

Dry suction is a type of chest tube management that utilizes a suction gauge to regulate the amount of suction applied without the use of water. The nurse in the video prefers dry suction because it is simpler to regulate and does not require maintaining a water level. The dry suction system is identified by the presence of an orange bellow, which indicates when suction is correctly applied.

💡Chest Tubes

Chest tubes are medical devices used to drain fluid or air from the pleural space, which is the area surrounding the lungs. In the script, the nurse explains the differences between two types of chest tubes, one for wet suction and one for dry suction, and how to manage them accordingly.

💡Drainage Chamber

The drainage chamber is a part of the chest tube system designed to collect fluids such as blood or pleural effusion. The nurse mentions that if there is blood in the drainage chamber, it indicates a hemothorax, a condition where blood accumulates in the pleural space.

💡Water Seal Chamber

The water seal chamber is crucial in chest tube management as it allows air to escape from the pleural space while preventing air from re-entering. The nurse explains that consistent bubbling in this chamber suggests an air leak, which is an important sign to monitor.

💡Air Leak

An air leak occurs when air escapes from the lungs into the pleural space. The nurse discusses how to identify an air leak through the water seal chamber by observing consistent bubbling, which can indicate conditions like a pneumothorax.

💡Hemothorax

Hemothorax is a medical condition characterized by the accumulation of blood in the pleural space. The script mentions that the presence of blood in the drainage chamber of a chest tube is indicative of a hemothorax.

💡Pneumothorax

Pneumothorax refers to the presence of air in the pleural space, which can cause the lung to collapse. The nurse explains that occasional bubbling in the water seal chamber could be a sign of a pneumothorax, especially if the patient is recovering from the condition.

💡Suction Gauge

A suction gauge is a device used to measure and regulate the amount of suction applied to a chest tube in a dry suction system. The nurse in the video discusses the challenges of using a suction gauge to ensure the correct level of suction is applied to avoid complications for the patient.

💡Pleurovac System

The Pleurovac system is a specific type of chest tube drainage system mentioned in the script. The nurse uses this system to illustrate the differences between wet and dry suction, and how to manage the suction levels for optimal patient care.

💡Sterile Water

Sterile water is used to maintain the water level in the suction chamber of a wet suction system. The nurse demonstrates the importance of refilling the water to the correct level to ensure proper suction function, which is a critical aspect of chest tube management.

Highlights

Introduction to the topic of wet versus dry suction in chest tube management.

Demonstration of two chest tubes to differentiate between wet and dry suction systems.

Importance of checking the drainage chamber for blood presence indicating a hemothorax.

Explanation of the water seal chamber's function in allowing air out but preventing air re-entry.

Identification of air leaks through consistent bubbling in the water seal chamber.

Differentiating between grades of air leaks based on bubbling patterns.

The absence of a third chamber in the Pleurovax system and its implications.

Use of a dial in the Pleurovax system to set provider-ordered suction levels.

The presence of an additional suction chamber in wet suction systems for monitoring applied suction.

Instructions on refilling the water to the 20 cm water line in the suction chamber.

Turning on suction to observe bubbling in the suction chamber as an indicator of proper function.

Preference for dry suction due to its ease of monitoring and fewer maintenance requirements.

The sensitivity of suction gauges and the need for careful regulation to avoid patient complications.

Demonstration of the orange bellow in the suction system indicating correct suction levels.

The importance of not having consistent bubbling in the water seal chamber except for occasional pneumothorax bubbles.

The expected bubbling in the wet suction chamber versus the dry suction's reliance on the bellow indicator.

Conclusion and invitation for viewers to ask questions or comment on the video.

Transcripts

hey nurse family today we're going to

talk about wet versus dry suction we're

going to talk about how to know which

one is which and how to manage one

versus the other okay um the differences

between the two so stick around okay so

what i have in front of you are two

chest tubes and hopefully you can figure

out which one is which as we go through

the different chambers that each of them

has so if you look at this stress tube

drainage system over here my pleurovax

system you notice that i have my

drainage chamber it goes up to 2500 okay

and if you notice there's blood there's

no blood here

okay which means that this system was

probably tipped over at some point and

this happens in the real world all the

time and what i'm not going to do is

leave it connected to the patient i'm

going to go get a new system because

it's going to be difficult for me to

determine how much drainage i actually

have if my drainage is not in the

correct chambers okay so if you ever saw

that you're going to go ahead and change

out the system

um so this is my drainage chamber and

you notice that there's blood in here so

that means my patient has a hemodorax

right

now if you look at this system over here

this patient

also has a hemothorax and also has a

drainage

um chamber and so this tubing that's

right here is the one connected to the

patient is going into their drainage

chamber okay

all right so they both have a drainage

chamber that's good the next thing we're

going to look at is this chamber here

and if you look they both have it so

this chamber here is called your water

seal okay both of these chest tubes um

are water seal right

what does the water seal do well it

allows air or whatever's in the pleural

space to come out

but it prevents air from going back in

the water seal chamber is where we're

going to see if our patient has any type

of air leak so this is very important

okay

if i have consistent bubbling in my

water seal chamber in either one of

these

then

that means i have an air leak

what you may see if my patient had a

pneumothorax you might see an occasional

bubbling right here in the one so each

number represents the grade of um

the air leak how severe it is so if i

have an intermittent bubble an

occasional bubble in the

first chamber that could just be that

you know my patient has a pneumothorax

and as it's resolving there's air

leaking into the chest tube which the

provider would be aware of as well as

the nurse and it would be well

documented so we're not worried about it

and evaluating something that does not

need to be evaluated okay

if there's greater than that if there's

a continuous bubbling then i need to

assess and i need to figure out where

this air leak is coming from is it my

system is it my tubing is it my patient

and i'm going to call the provider and

obviously evaluate how my patient is

doing as well

okay

now

in this plural vac system you'll notice

that i don't have a third chamber here

what i have

is this little

window

and a dial now the dial will allow me to

set whatever my provider has ordered

suction

and this dial

if there's no orange bellow here means

that i'm not connected to suction which

if you look i'm not connected to suction

right now it's so it's just to water

seal okay

so right now it's not on suction

versus

this system where you notice i do have

an additional chamber here so i have my

drainage my water seal and additional

chamber here and this is my suction

chamber this is how i'm going to

determine how much suction is being

applied so if you notice that there's a

little bit of water missing here that's

because it often evaporates right

so we're going to want to refill that so

what i would do right away is

go ahead and open up this little

tab there get my funnel with my sterile

water and fill my water to the 20

centimeter water line okay

there's no bubbling right now in this

chamber because again my suction is off

so right now there's no bubbling

but this is the chamber where i want to

see bubbling so i'm going to go ahead

and turn on my suction

so

my

favorite is the dry suction because with

the wet suction

not only do i have to make sure my water

is at the correct water line which it

often it can evaporate but also i want

to make sure that i have the correct

amount of suction i'm going to actually

increase the suction

so you can see what it looks like

so with this suction gauge it's very

sensitive and you can see

look how high my suction is now i don't

want to suction too high and i also

don't want to suction too low if i

suction too low i'm not going to suction

enough if i suction too high

that's going to cause it's going to

cause problems for the patient right

so this gauge that i have here is given

me a lot of trouble to regulate and so i

i'm really not getting it to the perfect

amount versus i want to show you now

unfortunately because this system has

been knocked over a few times

it's not working exactly the way it

should bring your attention right here

and you should see as i connect the

suction for a brief moment you're going

to see the orange bevel now in the real

world it should stay there as long as

i'm set to my 20 centimeters of suction

and my suction is on the bellow should

stay there here it snap and that's just

because my canister is not working

properly

oh there it is okay so i'm going to do

it one more time

so the orange bellow you saw it float up

and that's exactly what it would look

like it would float up but then it would

stay

there and as long as i have my orange

bellow and i have it set to 20 doesn't

matter what i have my gauge set for on

the wall that means i'm suctioning at

the appropriate review because this is

extremely important for your test in the

water seal chamber we should not have

bubbling there might be an intermittent

bubble with a pneumothorax but there

really shouldn't be consistent bubbling

there shouldn't be consistent bubbling

for

your suction chamber in your wet section

you should have bubbling

and in your dry suction you're just

looking for that bellow

hope this video is helpful as always if

you have any questions at the end of the

video feel free to write your comments

or questions down

[Music]