Chest Drainage Tubes (24-72 hours)

1. Continue milking of chest tube hourly. 
2. Monitor the amount, colour and record on the flow chart. 
3. Assess dressing for any soakage, any bulging and report immediately and record. 
4. X-ray chest. 
5. When chest drainage is less than 50ml/24hours, the chest tubes are removed. The patient is explained about the procedure, an analgesic is administered, encouraged to breath effectively, and the tube is pulled out, while the purse string suture is tightened to prevent air entry into the chest. The wound is properly sealed with adhesive and the patient is made comfortable. A chest x-ray is done after 4 hours to assess the chest for lung expansion and any collection of fluid. 
6. Encourage ambulation. (In some patients, the serous drainage may continue to drain, then the patient is allowed to ambulate with the chest drainage tubes and as the amount gets reduced, the tube is removed). 
7. Encourage breathing exercises and give chest physiotherapy and steam inhalation.