While in the hospital, there are several different types of systems used to drain excess fluid from the chest or abdominal cavity, With some illnesses, pleural effusion (fluid in the chest cavity) or ascites ( fluid in the abdominal cavity) is a recurring problem even after discharge from the hospital.
Historically it was necessary for patients for this periodic build-up of fluid to return to the hospital for drainage.
Thoracentesis (chest) or paracentesis (abdominal) drainage can now be done either by a home health nurse or the patient themselves depending on the situation. It usually takes less than half an hour and the rate of drainage can be controlled to maximize comfort of the patient.
When Pleurx was first introduced, it was taught as a sterile procedure.
Now, as you can see when you watch the video below, it is performed as a clean technique.
That being said, it is still imperative to understand that the implanted tube is a direct line to the internal cavities of the body. Introduction of harmful microorganisms can quickly lead to sepsis and re-hospitalization.
When cleaning the port of any type of line into the body, I always recommend at least 15 seconds of cleaning. An easy way to remember and teach patients is to sing “Happy Birthday” if they do not have a watch with a second hand available.
Hand hygiene before the procedure and after removing gloves, is part of standard precautions. Using either soap and water or hand sanitizer is acceptable.
The distal end of the line that is inserted in the patient, under the cap, has a one way valve. Removing the cap DOES NOT allow air to enter the tube. When pushing the tip of the line from the vacuum bottle into this distal end, you will feel a little resistance and a soft click as the two ends engage.
When replacing the cap, remember it is just a little piece of plastic, Use a gentle touch.
When coiling the line to cover with a new dressing, sometimes taking the end and tucking it loosely under the coil can keep it from unwinding before you put the transparent dressing on to secure it.
When teaching your patient this (or any procedure) it is good to demonstrate first, then have them practice hands on, themselves with you watching. They will need verbal prompting through the procedure, perhaps several times before they are able to perform it independently.
Some patients experience discomfort or pain when the fluid is draining. Usually, slowing the rate eases this. You can use the clamp, or you can take a portion of the tubing connected to the bottle and bend it in half, the more bent the slower the drain. You can have your patient control the rate if they wish.
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