![]() ![]() He is on the Board of Directors for the Intensive Care Foundation and is a First Part Examiner for the College of Intensive Care Medicine. He is also a Clinical Adjunct Associate Professor at Monash University. He is a co-founder of the Australia and New Zealand Clinician Educator Network (ANZCEN) and is the Lead for the ANZCEN Clinician Educator Incubator programme. Give prophylactic antibiotics (e.g.Chris is an Intensivist and ECMO specialist at the Alfred ICU in Melbourne.Reason why you never clamp the tube once it is in place (could cause tension pneumothorax).Clamp tube immediately take patient to the OR for emergent thoracotomy.Exsanguination (secondary to removing the tamponade effect of the hemothorax).For thoracic trauma, few data are available.Increased as indicated with the goal of achieving full lung expansion. ![]() Starting with Heimlich valve (no suction) or -10 cm of water and increasing only as needed.The least amount of suction (including none) needed to maintain full expansion of the lung is appropriate.Bronchial-pleural fistulae (large air leak).Trauma/bleeding (hemothorax/hemopneumothorax).Traumatic hemothorax ("any acute hemothorax visible on chest radiograph").Alveolar-pleural fistulae (small air leak).Most spontaneous pneumothorax (primary and secondary).Secure tube with silk suture and cover with gauze and cloth tape.Attach distal end of tube to the pleur-evac and place on suction (20-30cmH2O suction).If tube rotates easily, can help indicate correct location inside pleural cavity.Controversial as to whether this is important.Aim superoanterior for pneumothorax aim posteriorly for hemothorax.Feed the chest tube until all the holes are inside the thoracic cavity.It helps to have your finger in the tract and pass the tube along your finger, particularly in obese patients.Ensure that inner tract/incision can fit your finger and tube.Clamp the prox end of the chest tube and pass it along the tract into the pleural cavity. ![]()
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