Thoracic lavage: Difference between revisions
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== | ==Overview== | ||
*Active internal re-warming for hypothermic patients | *Active internal re-warming for hypothermic patients | ||
*Avoid left sided tubes in a perfusing patient since the heart is irritable. | *Avoid left sided tubes in a perfusing patient since the heart is irritable. | ||
==One Tube System== | ==Indications== | ||
Consider in: | |||
*Severe Hypothermia | |||
*Cardiovascular instability / life-threatening dysrhythmias | |||
*Moderate hypothermia which fails to respond to less aggressive measures | |||
==Contraindications== | |||
==Equipment Needed== | |||
==Procedure== | |||
===One Tube System=== | |||
*Single Lateral Thoracostomy Tube | *Single Lateral Thoracostomy Tube | ||
**Introduce large bolus of warmed saline | **Introduce large bolus of warmed saline | ||
**Allow fluid to sit for 15-20 mins and then drain | **Allow fluid to sit for 15-20 mins and then drain | ||
==Two Tube System== | ===Two Tube System=== | ||
[[File:thoraciclavage.png|thumb|Two Tube System]] | [[File:thoraciclavage.png|thumb|Two Tube System]] | ||
*Anterior Tube | *Anterior Tube | ||
| Line 22: | Line 29: | ||
**4-6th Intercostal space at post-axillary line | **4-6th Intercostal space at post-axillary line | ||
**Attach to continuous drainage via pleur-evac or auto-transfuser (if using autotranfuser can re-attach to warming line for closed circuit) | **Attach to continuous drainage via pleur-evac or auto-transfuser (if using autotranfuser can re-attach to warming line for closed circuit) | ||
==Complications== | |||
==See Also== | ==See Also== | ||
*[[Hypothermia]] | *[[Hypothermia]] | ||
*[[Chest tube]] | *[[Chest tube]] | ||
==External Links== | |||
==References== | ==References== | ||
Revision as of 16:47, 1 June 2017
Overview
- Active internal re-warming for hypothermic patients
- Avoid left sided tubes in a perfusing patient since the heart is irritable.
Indications
Consider in:
- Severe Hypothermia
- Cardiovascular instability / life-threatening dysrhythmias
- Moderate hypothermia which fails to respond to less aggressive measures
Contraindications
Equipment Needed
Procedure
One Tube System
- Single Lateral Thoracostomy Tube
- Introduce large bolus of warmed saline
- Allow fluid to sit for 15-20 mins and then drain
Two Tube System
- Anterior Tube
- Site at 2nd-3rd intercostal space at the midclavicular line
- Attach to a high rate infuser at 40-45°C
- Infuse 200 to 300mL
- This tube can be a pigtail
- Lateral Tube
- 4-6th Intercostal space at post-axillary line
- Attach to continuous drainage via pleur-evac or auto-transfuser (if using autotranfuser can re-attach to warming line for closed circuit)