![]() The type and location of drain insertion should be clearly identified in the LDA section of the patients EMR. Types of Drains inserted in the pleural and mediastinal space Tamponade: Is an acute effusion caused by the accumulation of fluid in the pericardial space, resulting in reduced ventricular filling and subsequent hemodynamic compromiseĬhest Drain Management Clinical Guideline.Thoracotomy: Incision into the chest wall either made on the side or under the arm to gain access to the heart for certain cardiac procedures.Sternotomy: Surgical procedure in which a vertical inline incision is made along the sternum, after which the sternum itself is divided to provide access to the heart.Pericardial Space: The space between the layers of the pericardium that contains fluid that lubricates the membrane surfaces of the heart and allows easy heart movement.Pleural Effusion: Increased fluid in the pleural space.Pleural Cavity: The potential space between the two pleurae (visceral and parietal) of the lungs.Mediastinum: The region between the pleural sacs, containing the heart and all of the thoracic viscera except the lungs.Cardiac surgical procedures: Please refer to the cardiology intranet site.Management of UWSD can be found in the following link: To provide a description of the types of drains available and to describe the safe and competent nursing management of Redivacᵀᴹ and Jackson-Prattᵀᴹ drains in the post-operative cardiac surgical patient. NB: Passive drainage systems with an attached collection bag (such as a urine or bile bag) is not used following cardiothoracic surgery. The type of drain inserted are closed systems and include: the AtriumTM underwater sealed drain (UWSD) (Atrium Ocean, Atrium Medical, Hudson, USA), the Redon RedivacTM drain (PFM Redon system, Mepro, Koln Germany), the Jackson-PrattTM drain (Cardinal Health, Waukegan, Illinois) and/or the ConvaTec MinivacTM drain (ConvaTec, NewZealand). Therefore negative pressure drains are placed in the mediastinum and pleural cavities. ![]() Drainage of fluid, or evacuation of air, from the pericardial and pleural spaces after cardiothoracic surgery is necessary to prevent effusions, tamponade or pneumothoraces and to also detect hemorrhage.
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