CARE OF DRAIN

CARE OF DRAIN. MALINA RANI SSN, DMCH. PRESENTED BY.

[Audio] Learning Objectives. LEARNING OBJECTIVES Explain the care of drain Discuss the purpose & indication of drain care Explain the classification of drain care Describe the complication and removal of drain care Explain the nursing care of drain.

To help eliminate dead space. To evacuate existing accumulation of fluid, to remove pus, blood, serous, bile. To prevent the potential accumulation of fluid. To prevent infection..

Definition A drain is a tube to allow fluid(blood, serum, pus, urine, feces, bile or lymph)or air that might collect at an operation site or in a wound to drain freely to the surface..

Septic wounds should be drained. Aseptic wounds those having oozing vessels or Large area. Wounds with chances of more fluid collection inside.( any operation) Leaking wounds from anastomosis. Any injury (stroke, any accident, head injury)..

A. Close drain-A drain system that is connected directly to pressure vessels is called a “pressure” or closed drain system. It’s formed by tubes in to a bag or bottle eg- N.G tubes foley’s catheter, chest, abdominal and orthopedic drains. B. Open drain-A drain system that collects liquids that spill on the ground is an “atmospheric” gravity” or open drain. drain fluid collects in gauze pad or stoma bag.eg- Penrose & corrugated drain..

Active drains- Active drains are closed systems that collect fluid into a reservoir. It’s apply an artificial pressure to pull fluid or gas from a wound or body cavity. Passive drains- Passive drains have no suction. Drains by means of pressure differentials, overflow and gravity between body cavities and the exterior..

N.G Tube Foly’s catheter Chest tube T –Tube drain Penrose drain. Pigtail drain. Redon drain Jackson pratt drain..

NASOGASTRIC TUBE(N.G tube). A nasogastric tube (NG tube) is a special tube that carries food and medicine to the stomach through the nose. It can be used for all feedings or for giving a person extra calories and other. Functioning of an N.G. tube properly placed and used for suction is maintain by flushing..

URINARY CATHETER. A urinary catheter is a hollow, partially flexible tube that collects urine from the bladder and leads to a drain. Catheters are generally necessary when some one can’t empty their bladder. Uses for-retention of urine incontinence &uncontrol urine etc..

A chest tube is a flexible plastic tube. It is also called inter costal catheter. That’s inserted through the chest wall and into the plural space for remove air, fluid or pus from the thoracic space. The most common indications for placement of a chest tube are:- 1.pneumothorax (simple or tension). 2. Hemothorax. 3. Hemopneumothorax. 4. Emphysema. 5. pleural effusion (acute or chronic) . Fig:-chest tube.

T-TUBE. T- Tube is a tube, that shaped like a T, the top of which is placed within a tubular structure such as the common bile duct.used for decompression, cholecystectomy etc..

The Penrose drain removes fluid from wound area.It can also be used to drain cerebrospinal fluid to treat a hydrocephalus patient. It also using for- plastic surgery, breast surgery, orthopaedic procedure etc. Fig: Penrose drain.

A pigtail catheter is a medical device.It is urine to drain directly from a kidney.pigtail drain let out the fluid area around the lungs. Fig:- Pigtail Drain.

Redon drain are used to channel secretions, blood and pus from the wounds or abscess. Functioning by gravity drainage system. Fig:- Redon drain.

JACKSON PRATT DRAIN. A Jackson-Pratt drain (also called a JP drain) is a close suction medical device that is commonly used as a post-operative drain for collecting bodily fluids from surgical sites. fig:- J.P drain.

A. Inefficient drainage: Obstruction Poor drain selection (diameter too small to remove viscous fluid) Erosion into hollow organs B. Incision dehiscence: Accumulation of fluid Poor placement Premature removal.

C. Infection: Ascending of bacterial invasion Foreign body reaction Fluid Accumulation Poor post operative management D. Discomfort / Pain: Chest tubes (diameter too large) Stiff Tubing.

E. Blockage: Temperature is above100`5F or higher The drain is cloudy or has bad odor. The drainage stops suddenly when the drain has been steadily putting out fluid..

REMOVAL OF SURGICAL DRAIN.

Drains should be removed once the drainage has stopped or becomes less than about 25ml/day Warn the patient that there may be some discomfort when the drain is pulled out. Ensure plan for removal of drain tubing. Explain the patient/parent about removal and possible pain..

Using standard aseptic technique cleans around the site and removes any sutures. Pinching the edges of the skin together, rotate tubing from side to side gently to loosen, and then remove the drain using a smooth,but fast. Place a dry dressing over the site where the drain was removed. Documented by the patient’s progress notes..

Assess of drain insertion site for signs of leakage,redness or sign of ooze, potency of drain is secured with suture or tape. Document site condition and notify on duty doctors. Ensure drain is located below the insertion site and free from kinks or knots..

Note and document amount and type of fluid in drain bottle. Monitor patient for signs of sepsis if the patient is febrile, has redness,tenderness,or increased ooze at the drain site. This could be a sign of infection then inform the responsible doctors and blood cultures may need to be obtained..

Drain patency and insertion site should be observed at the begening of our shift and before and after moving a patient. If applicable, ensure suction is maintained. Drainage needs to be documented at a minimum 4 hourly and more frequently if output is high. Clean the drain Insertion site daily with 0.9% normal saline by using aseptic technique..

Empty the collection bulb on the drain 3 times daily (or more often if needed). Drains should be removed under observation.Like-tape, suture, development of granulation tissue around the drain site. A blocked drain tube can lead to formation of hematoma and increased pain and risk of infection..

Education patient or parent to ensure the drain is below the site of insertion but not pulling on the patient. Education the patient or parent that there is a risk of dislodgement, requiring increased care when moving. Patient should be aware that moving whilst drain is in situ will cause some pain. But this can be minimized with regular analgesia..

REFERENCES:-. 1.https://www.healthline.com/health/urinary-catheters#uses. 2.slideshare.net.com 3.todaysvetrinary.practice.com 4.www.docheckupshop.eu 5.https://us.search.yahoo.com/yhs/search PURPOSE OF N.G.TUBE.

Quiz: Care of Drain. Please answer the following questions. (with Y or X except # 1,5B) Name the fluids to be drained from body. The drainage system inserted is based on only the needs of patient, and surgeon preference. Drainage needs to be documented at a minimum 8 hourly and more frequently if output is high and notify on duty doctors. Drains should be removed once the drainage has stopped or becomes less than about 40ml/day A) Passive drains are maintained under suction. B) How to assess a drain which is inserted in body..

Answer: Care of Drain. Please answer the following questions. (with Y or X except # 1,5B) Name the fluids to be drained from body. - The fluid to be drained may include: -blood, serum, pus urine, feces, bile or lymph. The drainage system inserted is based on only the needs of patient, and surgeon preference. X Drainage needs to be documented at a minimum 8 hourly and more frequently if output is high and notify on duty doctors. X Drains should be removed once the drainage has stopped or becomes less than about 40ml/day. X A) Passive drains are maintained under suction. X B) How to assess a drain which is inserted in body. Assess of drain insertion site for signs of leakage, redness or sign of ooze document site condition and notify on duty doctors. Assess if drain is secured with suture or tape document. Assess potency of drain. Ensure drain is located below the insertion site and free from kinks or knots. Note and document amount and type of fluid in drain bottle. Monitor patient for signs of sepsis if the patient is febrile, has redness tenderness, or increased ooze at the drain site, this could be a sign of infection, then inform the responsible doctors and blood cultures may need to be obtained..

THANKS.