Respiratory Pleural and Thoracic Injury. Marnie Quick, RN, MSN, CNRN Revision: 2011. Thoracic cavity. Lungs Mediastinum Heart Aorta and great vessels Esophagus Trachea. Breathing: inspiration.
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Marnie Quick, RN, MSN, CNRN
Lungs are surrounded by thin tissue called the pleura, a continuous membrane that folds over itself
Normally, the two membranes are separated only by the lubricating pleural fluid
Fluid reduces friction, allowing the pleura to slide easily during breathing
Normal Pleural Fluid Quantity: Approx. 25mL per lung
Intrapleural pressure: -8cmH20
If air or fluid enters the pleural space between the parietal and visceral pleura, the -4cmH20 pressure gradient that normally keeps the lung against the chest wall disappears and the lung collapses
Intrapulmonary pressure: -4cmH20
malignancy; pulmonary embolus; complication anticoagulant therapy
Suture tube to chest
Explore with finger
Place tube with clamp
Photos courtesy trauma.org
Chest tube is attached to a drainage device
Tube open to atmosphere vents air
Tube from patient
The depth of the water in the suction bottle determines the amount of negative pressure that can be transmitted to the chest, NOT the reading on the vacuum regulator
time – getting better or worse?