WHAT YOU NEED TO KNOW:

What is a chest tube? A chest tube is also known as chest drain or chest drainage tube. It is a plastic tube that is put through the side of your child's chest. It uses a suction device to remove air, blood, or fluid from around your child's lungs or heart. A chest tube will help your child breathe more easily.

Why may my child need a chest tube?

• Pneumothorax: This is a condition in which air escapes from the lung into the pleural space. The pleural space is the area between your child's lungs and chest wall. A pneumothorax makes it difficult to breathe. This can happen with a traumatic chest injury, such as a rib fracture. A pneumothorax may happen if your child has a ventilator or may be caused by an internal injury.
  
  
• Pleural effusion: This happens when fluid builds up in pleural space from certain lung conditions such as infection or a tumor.
  
  
• Empyema: This is an infection in the pleural space.
  
  
• Parapneumonic effusion: This is when your child has pleural effusion, a lung infection, and pus in his pleural space.
  
  
• Hemothorax: This is when blood leaks into the pleural space. A traumatic chest injury, a tumor, or bleeding problems may cause a hemothorax.

What happens after my child has a chest tube inserted?

• Medicines:
  • Antibiotics: This medicine is given to help prevent or treat an infection caused by bacteria.
    
    
  • Pain medicine: Your child may be given medicine to take away or decrease pain. Do not wait until the pain is severe before you give your child his medicine.
    
    
  • Tests: Your child may need a chest x-ray or a CT scan after his chest tube is inserted to check if it is in the right place. He may also need an x-ray after his chest tube is removed.
  
  

How can I help prevent problems with my child's chest tube?

• Help your child deep breathe and cough: This helps to open your child's airways and bring up mucus from his lungs. Your child should deep breathe and cough every hour while he is awake. Your child may hold a pillow tightly over the tube insertion area to decrease pain when he coughs. Your child should take a deep breath and hold it as long as he can. Then he should push the air out of his lungs with a deep strong cough. He may be given an incentive spirometer. This device helps your child take deeper breaths. Put the plastic piece into your child's mouth and ask him to take a deep breath. Tell your child to hold his breath as long as he can, then breathe out. Have your child use the incentive spirometer 10 times in a row every hour while he is awake.
  
  
• Ask about exercise: This may help prevent blood clots from forming and may help keep your child's lungs filled with air. Ask your child's healthcare providers if you can help him walk or do exercises while he is in bed.
  
  
• Help your child find a comfortable position: If your child complains of a burning feeling in his chest while lying in bed, help him to change his position. This may decrease his pain.
  
  
• Check your child's chest tube for kinks or loops: Make sure the tube is laid out on the bed close to your child. Do not let loops of tubing hang over the bed. The tubing should be long enough so that it will not be pulled out when your child moves or turns. If your child's chest tube gets disconnected, tell healthcare providers immediately.
  
  
• Keep the suction device below the level of your child's chest: This will help the fluids drain out from your child's chest to the container below. This will also help prevent fluids from flowing back into your child's chest.
  
  
• Make sure your child's chest tube is secure: Make sure the chest tube is securely taped to your child's body below his bandage. The chest tube may also be taped to the suction device to prevent the tubes from coming apart.

What are the risks of chest tubes in children?

• Your child may get an infection, or the place where the tube goes in may bleed too much. Your child's organs, blood vessels, or nerves may get damaged. Your child could have chest pain after the procedure. Your child may need to have the procedure again if the tube gets pulled out. If your child's condition comes back after treatment, he may need another chest tube. The chest tube may not decrease your child's signs and symptoms, or your child's healthcare provider may not be able to insert the tube. If this happens, your child may need to have another procedure or surgery.
  
  
• If you do not want your child to have a chest tube inserted, he may have more trouble breathing. If your child does not get enough oxygen, his heart and brain may be damaged. This can be life-threatening.

When should I contact my child's healthcare provider? Contact your child's healthcare provider if:

• Your child has a fever.
  
  
• Your child starts to vomit.
  
  
• Your child's pain does not go away, even after pain medicine has been given.
  
  
• Your child's skin is itchy, swollen, or has a new rash.
  
  
• The area where the tube is inserted is swollen, red, or has pus coming from it.
  
  
• You have questions or concerns about your child's condition or care.

When should I seek immediate care?Seek care immediately or call 911 if:

• Your child's bandage comes off.
  
  
• Your child has sudden chest pain.
  
  
• Your child has sudden trouble breathing.
  
  
• Your child's bandage becomes soaked with blood.
  
  
• Your child's stitches come apart.

CARE AGREEMENT:

You have the right to help plan your child's care. Learn about your child's health condition and how it may be treated. Discuss treatment options with your child's caregivers to decide what care you want for your child.