Patient education: How to care for a chest tube or catheter (The Basics)

What is a chest tube or catheter? — Chest tubes or catheters are used to drain air or fluid from the area around the lungs:

●A chest tube is made of flexible plastic and can be as thin as a pencil or as wide as a penny.

●A catheter is a smaller tube (thinner than a pencil).

You might also hear the term "thoracostomy" tube or catheter.

One end of the chest tube or catheter is inside the chest, between the ribs, and the other end is on the outside of the chest. The chest tube might be stitched into place where it comes out of the body. There might be a special 1-way valve on the end of the tube or catheter. This valve lets air and fluid drain out of the chest and makes sure that no air goes back into the chest. This helps the lungs expand more and heal faster.

The tube or valve might be connected to some kind of "collection system." This can be a:

●Drainage bag

●Plastic "collection chamber" or other type of drainage unit

How do I care for myself at home? — Ask the doctor or nurse what you should do when you go home. Make sure that you understand exactly what you need to do to care for yourself. Ask questions if there is anything you do not understand.

Before you go home, your doctor or nurse will talk to you about the kind of tube or catheter you have and how to care for it. This includes how to keep the area clean to help prevent infection. You will also need to check that the tube is working correctly. Each device comes with its own specific instructions.

You might need a family member or friend to help you care for yourself. Some people have a home health nurse come to their home to help with this.

To check the chest tube or catheter and make sure that it is working right:

●Look at the tube or catheter and bandage every day. Fluid in the tube should move back and forth slightly when you breathe, and flow freely into the drainage bag or collection chamber.

●Look for redness, swelling, or leaking around where the tube enters your body.

●Make sure that the drainage bag or collection chamber is lower than your chest at all times. This will help the fluid drain into the chamber properly and keeps it from moving back into your chest.

●Make sure that the tube or catheter doesn't have any kinks. Also make sure that the tubing goes in a straight line downward and is off of the floor. This makes sure that the fluid drains properly and doesn't get stuck anywhere in the tubing.

●Your doctor or nurse will tell you how to drain the fluid from the collection system, if needed. Every collection system is different, so follow all instructions. Your doctor or nurse will also tell you if you need to measure the fluid that collects, and how often to do this.

You will also sometimes need to change the bandage covering the chest tube or catheter. Your doctor or nurse will tell you how often to do this. In general, the bandage needs to be changed every few days, or if it is loose, wet, or dirty. You will probably need another person to help you with this to make sure that the tube doesn't move out of place.

To change the bandage:

●You and the person helping you will need 2 pairs of clean gloves each, a new bandage, a trash bag, a clean pair of scissors, and a special soap to clean around the tube or catheter. You might get these supplies from a home health agency. Ask your doctor or nurse if you have any questions about supplies.

●Wash your hands, and put on a pair of clean gloves.

●Carefully take off the old bandage while holding the chest tube in place. Do not pull on the chest tube. Throw the old bandage in the trash bag.

●Take off your gloves. Wash your hands again, and put on the other pair of clean gloves.

●Use the special soap to clean the skin around the chest tube. Let it air dry.

●Once the area around the tube is dry, put a new bandage over the area:

•Take a piece of gauze, and cut a slit in it halfway up using a clean pair of scissors.

•Place the gauze around the chest tube or catheter so that the end of the tube fits between the slit.

•Cover the gauze fully with a clear dressing or medical tape. This helps keep the tube or catheter from moving around or pulling out.

●Put a piece of medical tape over the tube or catheter below the new dressing to help keep it in place. This tape goes over the tubing and onto your skin.

●Take off the gloves, and wash your hands.

If the tube or catheter pulls out, do not try to push it back in. Call your doctor right away. If you start to have trouble breathing, call for emergency help (in the US and Canada, call 9-1-1).

What else should I know? — You can do many of your normal activities while the tube or catheter is in. But don't do anything that might cause the tube to move out of place. Your doctor or nurse will tell you if there are specific activities you should avoid.

The tube or catheter and bandage shouldn't get wet. Do not take a bath, go swimming, or get in a hot tub while the tube or catheter is in place. Your doctor or nurse will tell you if you can take a shower, and how to protect the tube or catheter from getting wet. This will depend on why you have the tube and which collection system you have.

When should I call the doctor? — Call your doctor or nurse if you:

●Have a hard time breathing, or feel weak, dizzy, or faint

●Feel like your heart is pounding or beating very fast

●Have problems with the drainage, such as:

•There is a sudden increase of bright red drainage (blood) in the drainage bag or collection chamber.

•There are changes in the color, thickness, or amount of drainage, especially if it looks bloody or cloudy or smells bad.

•The drainage stops completely, or there is only a small amount.

•The drainage is leaking out from the chest tube or catheter insertion site.

•You have pain – Call your doctor if you have pain in your chest. They might be able to give you medicines to help.

●Have signs of an infection, including:

•Fever of 100.4°F (38°C) or higher

•Chills

•Cough

•New phlegm or a change in color of phlegm – Phlegm is a mixture of saliva and mucus that you cough up.

●Have problems with the tube or catheter, such as:

•There are blood clots in the tubing.

•The tube or catheter leaks or cracks.

•The tube or catheter comes out – If the tube or catheter comes out, do not try to push it back in. Call your doctor right away. A new tube or catheter might need to be placed.

•There is swelling, redness, warmth, or pain on the skin around the tube or catheter.

•The tube or catheter disconnects from the drainage bag or collection chamber – Clean both ends of the tube or catheter and reconnect. Call your doctor right away. A new tube or catheter might need to be placed.

More on this topic

Patient education: Chest tubes and catheters (The Basics)
Patient education: Pneumothorax (collapsed lung) (The Basics)
Patient education: Pleural effusion (The Basics)
Patient education: Pleuritic chest pain (The Basics)

Patient education: Thoracentesis (Beyond the Basics)