Q Are chest tubes routinely milked, stripped, or suctioned to maintain patency? Do staff nurses irrigate chest tubes with small amounts of isotonic sodium chloride to break up clots?

A Peggy Kirkwood, RN, MSN, CS-ACNP, replies: ______

Chest tubes are placed in the pleural or the mediastinal space to evacuate an abnormal collection of air or fluid that collects as a result of injury, disease, or surgical procedures. Three primary objectives in caring for the patient with chest tubes are the following:

Although some form of chest drainage has been used for centuries, there is still much to learn about many aspects of chest tube management. Research has concentrated on the amount of suction needed for chest tube drainage systems, the effects of that suction, and the practice of milking and stripping chest tubes. Unfortunately, there has been limited research in other areas of chest tube management, such as irrigation...

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