PROCEDURE

1. If only water seal ordered, fill the water seal

chamber/bottle with sterile water or saline to the 2 cm
level. Provides a water seal and prevents air from enter-
ing the pleural cavity. The 2 cm level is sufficient to cre-
ate a one-way valve to prevent air from entering the
pleural cavity through the chest tube. Underfilling leaves
water seal chamber/bottle tube exposed to air; overfilling
inhibits air from exiting pleural space.

2. If suction ordered, fill suction control chamber/bottle to

the ordered level of fluid, usually 10–20 centimeters of
water. Provides extra suction to increase drainage from
the pleural cavity.

3. If suction ordered, attach suction tubing to the marked

suction port and to the suction source. Provides suction
to the system.

4. Turn on suction. Increase level of suction until there is

gentle bubbling in the suction control chamber/bottle of
the system. Level of suction determined by air flow
through the water in the suction chamber/bottle. Air
flow indicated by water bubbling in the suction control
chamber/bottle.

5. Set up the system at the child’s bedside keeping

drainage system below the level of the child. Prevents
back flow of fluid or air into the pleural cavity.

DOCUMENTATION

1. Level of water seal.
2. Level of suction.

89

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SKILL 40

SKILL 40

Preparing the Chest Tube Drainage System