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. | ||
* | *Rewarms at a rate of 3°C/hr | ||
==Two 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 | |||
**Introduce large bolus of warmed saline | |||
**Allow fluid to sit for 15-20 mins and then drain | |||
===Two Tube System=== | |||
[[File:thoraciclavage.png|thumb|Two Tube System]] | |||
*Anterior Tube | *Anterior Tube | ||
**Site at 2nd-3rd | **Site at 2nd-3rd intercostal space at the midclavicular line | ||
**Attach to a high rate infuser at 40-45°C | **Attach to a high rate infuser at 40-45°C | ||
**Infuse 200 to 300mL | |||
**This tube can be a pigtail | **This tube can be a pigtail | ||
*Lateral Tube | *Lateral Tube | ||
**4-6th Intercostal space at post-axillary line | **4-6th Intercostal space at post-axillary line | ||
**Attach to continuous drainage | **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== | |||
*[[Hypothermia]] | |||
*[[Chest tube]] | |||
==External Links== | |||
==References== | |||
<references/> | |||
[[Category:Environmental]] | |||
[[Category:Procedures]] | |||
Latest revision as of 00:14, 13 May 2019
Overview
- Active internal re-warming for hypothermic patients
- Avoid left sided tubes in a perfusing patient since the heart is irritable.
- Rewarms at a rate of 3°C/hr
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)