What are the functions of a chest tube and drainage system in a patient with chest trauma that causes a Hemothorax and or a pneumothorax?
Hemothorax is a collection of blood in the space between the chest wall and the lung (the pleural cavity). Aortic rupture (a tear in the aorta,
which is the major artery coming from the heart) can be seen on a chest X-ray. In this case, it was caused by a traumatic perforation of the thoracic aorta. This is how the X-ray appears when the chest is full of blood (right-sided hemothorax) seen here as cloudiness on the left side of the picture. Air is breathed in through the nasal passageways, travels through the trachea and bronchi to the lungs. The pleural cavity is the space between the layers of the membrane lining the lung (pleura) and the chest cavity. The most common cause of hemothorax is chest trauma. Hemothorax can also occur in people who have: SymptomsExams and TestsYour health care provider may note decreased or absent breath sounds on the affected side. Signs or findings of hemothorax may be seen on the following tests:
TreatmentThe goal of treatment is to get the person stable, stop the bleeding, and remove the blood and air in the pleural space.
If a chest tube alone does not control the bleeding, surgery (thoracotomy) may be needed to stop the bleeding. The cause of the hemothorax will be also treated. The underlying lung may have collapsed. This can lead to breathing difficulty. In people who have had an injury, chest tube drainage may be all that is needed. Surgery may not be necessary. WHAT TO EXPECT AT THE EMERGENCY DEPARTMENT The provider will measure and monitor the person's vital signs, including oxygen saturation, pulse, breathing rate, and blood pressure. Symptoms will be treated as needed. The person may receive:
Outlook (Prognosis)The outcome depends on the cause of the hemothorax, the amount of blood loss and how quickly treatment is given. In the case of major trauma, the outcome will additionally depend on the severity of the injury and the rate of bleeding. Possible ComplicationsComplications may include:
When to Contact a Medical ProfessionalCall 911 or the local emergency number if you have:
Go to the emergency room or call the local emergency number (such as 911) if you have:
PreventionUse safety measures (such as seat belts) to avoid injury. Depending on the cause, a hemothorax may not be preventable. ReferencesLight RW, Lee YCG. Pneumothorax, chylothorax, hemothorax, and fibrothorax. In: Broaddus VC, Mason RJ, Ernst JD, et al, eds. Murray & Nadel's Textbook of Respiratory Medicine. 6th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 81. Raja AS. Thoracic trauma. In: Walls RM, Hockberger RS, Gausche-Hill M, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 9th ed. Philadelphia, PA: Elsevier; 2018:chap 38. Semon G, McCarthy M. Chest wall, pneumothorax, and hemothorax. In: Cameron AM, Cameron JL, eds. Current Surgical Therapy. 13th ed. Philadelphia, PA: Elsevier; 2020:1146-1150. Version InfoLast reviewed on: 7/1/2020 Reviewed by: Jesse Borke, MD, FACEP, FAAEM, Attending Physician at FDR Medical Services/Millard Fillmore Suburban Hospital, Buffalo, NY. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. What is the function of a chest tube?What Is a Chest Tube? A chest tube is a plastic tube that is used to drain fluid or air from the chest. Air or fluid (for example blood or pus) that collects in the space between the lungs and chest wall (the pleural space) can cause the lung to collapse.
What does a chest tube do for a pneumothorax?Chest tube insertion.
A flexible chest tube is inserted into the air-filled space and may be attached to a one-way valve device that continuously removes air from the chest cavity until your lung is re-expanded and healed.
What are the two major reasons to use a chest tube drainage system?Chest tubes can be effective at draining fluid and air from the pleural space. In many cases, it can help eliminate the need for a more invasive surgery.
What is the purpose of the use of suction with a chest tube and drainage system?Closed chest drainage systems use gravity and/or suction to restore negative pressure and remove air, fluid, and/or blood from the pleural space so that the collapsed lung can re-expand.
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