Chest Tube Basics

The pleural space is a potential space between the visceral and parietal pleura. Its normal pressure conditions help keep the lung expanded against the chest wall. Air, blood, infected fluid, or another pleural effusion occupying that space reduces the lung's ability to expand and may compress nearby lung tissue. A chest tube, or thoracostomy tube, creates a controlled route for evacuation. The tube connects to a drainage unit with a collection chamber and a water-seal chamber. The water seal functions like a one-way door: air can leave the pleural space, but atmospheric air should not flow backward into the chest. Removing the abnormal pleural contents allows the lung to re-expand when the underlying problem and lung mechanics permit it. The tube treats the pleural-space problem; it does not by itself correct the cause. A traumatic hemothorax may still be bleeding. A pneumothorax may still have an air leak. Pleural infection may still require antibiotics and source control. The patient's respiratory effort, oxygenation, circulation, and trend therefore matter more than the appearance of the collection chamber alone. For an LVN/LPN, the...