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Difference between revisions of "Thoracic lavage"
From WikEM
| Line 1: | Line 1: | ||
| + | ==Background== | ||
*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. | ||
| Line 5: | Line 6: | ||
**Cardiovascular instability / life-threatening dysrhythmias | **Cardiovascular instability / life-threatening dysrhythmias | ||
**Moderate hypothermia which fails to respond to less aggressive measures | **Moderate hypothermia which fails to respond to less aggressive measures | ||
| + | |||
| + | ==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== | ==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 | **Infuse 200 to 300mL | ||
| Line 14: | Line 21: | ||
*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) |
| − | + | ||
| − | + | ||
| − | == | + | ==See Also== |
| − | + | ||
| − | + | ||
| − | + | ||
| − | + | ||
| − | + | ||
*[[Hypothermia]] | *[[Hypothermia]] | ||
*[[Chest tube]] | *[[Chest tube]] | ||
| + | |||
| + | ==References== | ||
| + | <references/> | ||
[[Category:Environmental]] | [[Category:Environmental]] | ||
[[Category:Procedures]] | [[Category:Procedures]] | ||
Latest revision as of 04:30, 11 May 2017
Background
- Active internal re-warming for hypothermic patients
- Avoid left sided tubes in a perfusing patient since the heart is irritable.
- Consider in
- Severe Hypothermia
- Cardiovascular instability / life-threatening dysrhythmias
- Moderate hypothermia which fails to respond to less aggressive measures
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)
See Also
References
Authors
Justin Arndt, Lisa Yee, Ross Donaldson, Michael Holtz, Daniel Ostermayer
