HEMS Chest Tube Procedure Note

Procedure: Chest Tube

The decision to place a chest tube is based on: [checkbox name="indication" value="severe respiratory distress|mechanism of injury|objective signs of a pneumo/hemo thorax|positive identification of a pneumo/hemo thorax based on lack of sliding lung sliding as seen in the ultrasound exam "][text name="indication" size = 55 default=" "].

A procedural sedations was performed to facilitate patient comfort during the surgical procedure. – Reference the Sedation procedure note.

The procedure was started at [text name="variable_1" default=" "].

A time-out was completed verifying correct procedure, site, positioning, and special equipment readied. The patient was positioned appropriately for chest tube placement with arm on the affected side raised above the patients head. The patient’s [checkbox name="variable_1" value="left|right|bilateral"] chest was prepped and draped in sterile fashion. A 2 cm skin incision was made in the mid-axillary line at the inframammary crease. Utilizing blunt dissection, a subcutaneous tunnel was created cephalad just adjacent to the superior rib. The pleural space was entered bluntly and gush of [checkbox name="variable_1" value="air|blood"] was observed. A finger was inserted into the pleural space to check for anatomy and guide tube insertion. A 36F thoracostomy tube was inserted using a Rochester Pean and positioned appropriately. The chest tube was sutured securely to the skin and a sterile dressing applied. A pleurevac was attached to the chest tube and adjust to 20cm of H2O suction.  

Improvement noted by reduction in respiratory distress and improvement in objective signs of a pneumo/hemo thorax. 

The procedure ended at [text name="variable_1" default=" "].
Procedure: Chest Tube

The decision to place a chest tube is based on: .

A procedural sedations was performed to facilitate patient comfort during the surgical procedure. – Reference the Sedation procedure note.

The procedure was started at .

A time-out was completed verifying correct procedure, site, positioning, and special equipment readied. The patient was positioned appropriately for chest tube placement with arm on the affected side raised above the patients head. The patient’s chest was prepped and draped in sterile fashion. A 2 cm skin incision was made in the mid-axillary line at the inframammary crease. Utilizing blunt dissection, a subcutaneous tunnel was created cephalad just adjacent to the superior rib. The pleural space was entered bluntly and gush of was observed. A finger was inserted into the pleural space to check for anatomy and guide tube insertion. A 36F thoracostomy tube was inserted using a Rochester Pean and positioned appropriately. The chest tube was sutured securely to the skin and a sterile dressing applied. A pleurevac was attached to the chest tube and adjust to 20cm of H2O suction.

Improvement noted by reduction in respiratory distress and improvement in objective signs of a pneumo/hemo thorax.

The procedure ended at .

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