Background: Surgical Chest drain insertion is a lifesaving procedure. It requires skills and experience towards its prompt insertion. Quite often there is delay or failure caused in its insertion due to excessive fat ...Background: Surgical Chest drain insertion is a lifesaving procedure. It requires skills and experience towards its prompt insertion. Quite often there is delay or failure caused in its insertion due to excessive fat and loose skin in the axillary area while using the conventional methods. Numerous guidelines exist advising its safe placement, but mishaps still occur, as reported multiple times, while placing the chest drain. In addition to this, a delay or failure of its successful insertion can lead to disastrous consequences. Case: We would like to share, with fellow readers, a novel technique which we used in placing a surgical chest drain successfully. We used a gum bougie to guide the chest drain into the pleural cavity instead of using metal trocar, stellate or long forceps. Conclusion: By using this method, we experienced that not only it reduced the amount of time taken for the procedure, but it also had positive impact on the ease of insertion without fear of causing damage to internal organs, which ultimately boosted the operator’s confidence.展开更多
Positive pressure generated in peritoneal cavity by gas insufflation during laparoscopic procedures can cause hemodynamic instability. There are a few case reports suggesting similar occurrences during thoracoscopic p...Positive pressure generated in peritoneal cavity by gas insufflation during laparoscopic procedures can cause hemodynamic instability. There are a few case reports suggesting similar occurrences during thoracoscopic procedures as well. The mechanism behind the conditions above is explained to be due to stretch force applied to peritoneum and pleura which causes vagal stimulation. We wish to present a case where a high negative pressure applied to pleural cavity lead to treatment-resistant bradycardia. The possible mechanism behind this occurrence was traction pressure on pleura which triggered vagal activity. The bradycardia subsided on reducing or discontinuing negative suction pressure. To best of our knowledge this the first case report on bradycardia associated with high negative suction pressure applied to inter costal drain.展开更多
目的:总结胸腔闭式引流最佳证据并探讨其在临床护理实践中的应用效果。方法:根据PIPOST原则界定循证问题及检索策略,检索Up To Date,PubMed、EMbase、The Cochrane Library、JBI、中国知网、万方等数据库,获得胸腔闭式引流挤捏、夹闭、...目的:总结胸腔闭式引流最佳证据并探讨其在临床护理实践中的应用效果。方法:根据PIPOST原则界定循证问题及检索策略,检索Up To Date,PubMed、EMbase、The Cochrane Library、JBI、中国知网、万方等数据库,获得胸腔闭式引流挤捏、夹闭、应急处理、监测、疼痛护理等方面的最佳证据,并应用于临床护理实践。结果:将整合形成的胸腔闭式引流最佳证据推荐意见11条应用于临床护理实践,应用后护士胸腔引流管护理理论考核成绩由(73.53±9.28)分提高到(83.54±9.67)分,应用前后评分比较差异有统计学意义(P<0.01);护士挤管、夹管及转运、应急处理、疼痛护理、肺功能锻炼护理规范操作依从率均有提高。结论:将最佳证据应用于临床护理实践,有助于提高护士的理论水平及规范操作依从性,进而提高胸腔闭式引流护理质量。展开更多
文摘Background: Surgical Chest drain insertion is a lifesaving procedure. It requires skills and experience towards its prompt insertion. Quite often there is delay or failure caused in its insertion due to excessive fat and loose skin in the axillary area while using the conventional methods. Numerous guidelines exist advising its safe placement, but mishaps still occur, as reported multiple times, while placing the chest drain. In addition to this, a delay or failure of its successful insertion can lead to disastrous consequences. Case: We would like to share, with fellow readers, a novel technique which we used in placing a surgical chest drain successfully. We used a gum bougie to guide the chest drain into the pleural cavity instead of using metal trocar, stellate or long forceps. Conclusion: By using this method, we experienced that not only it reduced the amount of time taken for the procedure, but it also had positive impact on the ease of insertion without fear of causing damage to internal organs, which ultimately boosted the operator’s confidence.
文摘Positive pressure generated in peritoneal cavity by gas insufflation during laparoscopic procedures can cause hemodynamic instability. There are a few case reports suggesting similar occurrences during thoracoscopic procedures as well. The mechanism behind the conditions above is explained to be due to stretch force applied to peritoneum and pleura which causes vagal stimulation. We wish to present a case where a high negative pressure applied to pleural cavity lead to treatment-resistant bradycardia. The possible mechanism behind this occurrence was traction pressure on pleura which triggered vagal activity. The bradycardia subsided on reducing or discontinuing negative suction pressure. To best of our knowledge this the first case report on bradycardia associated with high negative suction pressure applied to inter costal drain.
文摘目的:总结胸腔闭式引流最佳证据并探讨其在临床护理实践中的应用效果。方法:根据PIPOST原则界定循证问题及检索策略,检索Up To Date,PubMed、EMbase、The Cochrane Library、JBI、中国知网、万方等数据库,获得胸腔闭式引流挤捏、夹闭、应急处理、监测、疼痛护理等方面的最佳证据,并应用于临床护理实践。结果:将整合形成的胸腔闭式引流最佳证据推荐意见11条应用于临床护理实践,应用后护士胸腔引流管护理理论考核成绩由(73.53±9.28)分提高到(83.54±9.67)分,应用前后评分比较差异有统计学意义(P<0.01);护士挤管、夹管及转运、应急处理、疼痛护理、肺功能锻炼护理规范操作依从率均有提高。结论:将最佳证据应用于临床护理实践,有助于提高护士的理论水平及规范操作依从性,进而提高胸腔闭式引流护理质量。
