Chest tubes

All patients return from the operating room with anywhere from one to three chest tubes in place. It is routine for our patients to receive an anterior and posterior mediastinal chest tube; however, any dissection into either the right or the left hemithorax or in cases where the internal mammary was taken down, an additional chest tube may be placed in the respective hemithorax. It is the resident's responsibility to inspect these tubes and to ensure that all junctions are secured air tight. The chest tubes should be connected to a Pleur-Evac suction apparatus with -20 cm of water suction. These tubes should be inspected frequently to determine the rate of postoperative bleeding and air leak. No patient should ever have his or her chest tube opened under any condition without contacting the Chief Resident or attending physician first. The Pleur-Evac system is a closed system and therefore opening it violates surgical sterile technique. Any clots appearing in the chest tubes themselves may be drained by gently tapping the tube with a metal object or one's hand. Routine chest tube stripping is not allowed.

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