Effects of two chest tube clearance protocols on drainage in patients after myocardial revascularization surgery
Article Abstract:
Patients that have undergone heart surgery require chest tubes to clear excess blood that can accumulate in the chest cavity. Cardiac tamponade, cessation of blood flow to the heart caused by excess pressure, can occur if the drainage is not performed carefully. Nurses are usually responsible for clearing the drainage from the tubes. A number of methods are used, but no clear basis for which is best has been established. Gravity or suction from the drainage system are preferred in tube clearance, but sometimes more pressure is needed to clear the tubes. Milking and stripping the tubes are often used when more pressure is needed, such as when blood clots clog them. Milking involves manually squeezing and twisting the tube to remove a clot. Stripping involves continuous compression of the tube using a hand-held roller. This study examined and compared the two methods used to clear chest drainage tubes in patients who have had heart surgery to see if there were any differences in drainage ability or side effects. The study followed 200 patients who were randomly put in either a milking group or a stripping group, 100 in each group, after they had undergone surgery and chest tubes were in place. In 103 patients, the tubes did not have to be cleared or only had to be cleared once. Total drainage after eight hours was not significantly different between the groups. Incidence of adverse effects requiring additional surgery was similar in both groups. The number of required manipulations of tubes was not significantly different between the groups. These results indicate that milking and stripping of chest tubes is not often needed in the first eight hours after surgery. They also indicate that when such manipulation is needed, either method is equally effective in removing clots. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Heart and Lung
Subject: Health
ISSN: 0147-9563
Year: 1991
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Family relationships during serious illness
Article Abstract:
Serious illness in an individual affects the whole family. Family members have to reassess their roles and their views of themselves, and they have to balance the demands of the illness with the needs of other family members. There may have to be changes to family rules and the overlap of the family system and the professional care system has to be negotiated. Some people are able to undertake these processes more easily than others. Nurses may have to help families deal with the changes encountered, but they should also be aware of effects on themselves and their own family lives.
Publication Name: Nursing Times
Subject: Health
ISSN: 0954-7762
Year: 1997
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