Care of patient with icd

ICD care

1. INTRODUCATION If a patient come in emergency department with the complain of sever chest trauma on X-ray examination doctor find that he is having right side hemo -thorax. What would be the invasive intervention done by the doctor to remove fluid….?

2. Care Of Patient With Chest Drainage System

3. What Is intra-costal drainage A chest tube is a catheter inserted through the thorax to remove air and fluids from the pleural space, to prevent air or fluid from re- entering the pleural space, or to Re-establish normal intrapleural and intrapulmonic pressures

4. Purpose Of Chest Tube Placement: Remove fluid & air as promptly as possible Prevent drained air & fluid from returning to the pleural space Restore negative pressure in the pleural space to re-expand the lung

5. How A Chest Drainage System Works: Expiratory pressure Gravity Suction

6. NURSING CARE PRE PROCEDURE INTRA-PROCEDURE POST PROCEDURE

7. PRE PROCEDURE Identify the patient Monitor the patient vitals Explain about the procedure Inform consent & procedure consent. Preparation of articles and environment

8. INTRA-PROCEDURE Marking the sites Pre- procedure medication Provide position as per procedure Access IV line Assist the procedure with aseptic technique Monitor patient vitals in between

9. Nursing care Keep a chest tube system closed and below the chest The tube should be secured to the chest wall. Watch for slow, steady bubbling in the suction-control chamber and keep it filled with sterile water at the prescribed level.

10. POST PROCEDURE Monitor patient vitals and comfort Replace the articles and recording & reporting ( Documentation ) Assess the pain by pain scale and management

11. Special consideration watch for fluctuation (tidaling) of the fluid level to ensure that the chest tube is in place If fluctuation is less the 2 cm look for blockage If blockage is present milking is done Make sure connections are tight and taped Report any unexpected cloudy or bloody drainage . Assist the dressing and if any exudates is present send for culture

12. Cont…. Check for bubbling Mark the level on the outside of the collection chambers every shift. Do not let the tubing kink or loop Drainage bag should be below the chest level

13. Encourage your patient to cough, deep breath, and use the incentive spirometer. Advice for ROM if not contra-indicated Routinely a ccess respiratory rate, breath sounds, SpO2 levels . Check for insertion site & skin inspection

14. ……. Precautions Clamping a chest tube is contraindicated when ambulating or transporting a patient. Clamping can result in a Tension Pneumothorax

15. INDICATION FOR REMOVING ICD Drainage less than 50-100ml of fluid per day. 1-3 days post cardiac surgery. 2-6 days post thoracic surgery.

16. RESEARCH ARTICALS Problem statement:- Nurses’ knowledge and Practice regard Care of Patient with Chest Drain. Researcher name :- Dr. Badria A. Elfaki , Dr. Hassanat E. Mustafa , Prof. Alaadin Hassan Ahmed. Aim :- The study aim to assess nurses’ knowledge and practice for patient connected to chest drain

17. Design:- A descriptive design. Sample : -50 nurses. Setting :- Sudan Heart Centre hospital. Results:- knowledge : -All nurses were known chest drain is sterile procedure, and more than 60.0% were known the chest drain needs inform consent, indications and site of insertion. Although more than 60% of them didn’t know exactly underwater-seal, position of patient during insertion the tube, routine milking or striping will increase pleural pressure and mobility of patient with chest drain. Also nurses had average knowledge about the basic principles of drain function, complications, actions when tubes leakage, displacement or dislodge. Practice: - poor level of practice towards preparation of equipment for insertion the chest drains and routine patient care.

18. ASSIGNMENT Write nursing responsibility of a patient with ICD