WHAT YOU NEED TO KNOW:

What do I need to know about a chest or abdominal catheter? A chest or abdominal catheter helps remove fluid from your chest or abdomen. This may decrease symptoms such as shortness of breath, pain, or nausea. One end of the catheter sits inside your abdomen or chest. The other end sits outside of your body. Your healthcare provider will show you or your caregiver how to drain fluid through the catheter.

How is a chest or abdominal catheter inserted? You may be given local anesthesia to numb the area and medicine to help you relax. With local anesthesia, you may still feel pressure or pushing during the procedure, but you should not feel any pain. Your healthcare provider will make a small incision in your chest or abdomen and insert the catheter. The catheter will be held in place with stitches. Your healthcare provider will remove fluid through your catheter. He will place a bandage over the catheter when he is finished. The area may be sore or swollen for a few days. You may be given medicine to decrease pain.

How often should I drain fluid? Your healthcare provider will tell you how often to drain fluid. He may tell you to follow a schedule, such as draining once a day or once every other day. He may instead tell you to drain fluid when you have symptoms such as pain. Do not change how often you drain your catheter without talking to your healthcare provider.

What should I do before I drain fluid?

• Wash your hands. Remove all rings. Use soap and water or an alcohol-based hand rub. This will help prevent an infection.
  
  
• Gather your supplies. Get a drainage kit and place it on a firm, clean surface. Drainage kits contain either a 500 mL or 1000 mL bottle and a procedure kit. Your healthcare provider will tell you which bottle to use.
  
  
• Gently remove the old bandage. Do not pull on the drain when you remove the bandage. Throw the bandage away.
  
  
• Wash your hands a second time. Use soap and water or an alcohol-based hand rub.
  
  
• Open the drainage kit and remove the procedure kit. Remove the bandage and place it on your clean surface. Leave the bottle with drainage tubing in the package. Remove the procedure kit and place it on your clean surface with the folded side facing up. Carefully unfold the corners of the procedure kit. Do not touch anything inside of the procedure kit. Everything inside of the procedure kit is sterile.
  
  
• Prepare the drainage tubing and bottle. Uncoil the drainage tubing that is connected to the bottle. Do not touch the end of the drainage tubing. Do not remove the cover from the end of the drainage tubing. Lay the drainage tubing on the procedure kit.
  
  
• Put on gloves. Both gloves fit either hand. Pick up each glove up by the folded part and put them on. Do not touch any part of the outside of the gloves with your bare hand. Do not let them touch anything that is not sterile.
  
  
• Open the smaller packages inside of the procedure kit. Open the package that contains the new catheter cap. Let the cap gently fall onto the procedure kit. Tear open the alcohol pads, but do not remove them from their pouches.
  
  
• Squeeze or roll the clamp closed on the drainage tubing. If the clamp rolls, roll it towards the bottle.
  
  
• Remove the cap on the end of your catheter. Hold the catheter close to the cap. Twist the cap counter clockwise and pull it off gently. Throw the cap away. Do not let the end of the catheter touch anything.
  
  
• Clean the end of the catheter. Use 1 alcohol pad from the procedure kit. Wipe around the end of the catheter in circles. Do not put anything into the end of the catheter to clean it. This could damage the catheter.

How do I drain fluid from my catheter?

• Connect the end of your catheter to the drainage tubing. Remove the cover from the end of the drainage tubing. Hold the end of your catheter in one hand and the drainage tubing in your other hand. Insert the drainage tubing into your catheter until you hear or feel a click.
  
  
• Remove the lock clip on the bottle. Twist and pull gently to remove it.
  
  
• Push down on the bottle's plunger. Use 1 hand to hold the bottle steady. Push down gently on the T-shaped plunger at the top of the bottle. This will create a vacuum inside the bottle and help drain fluid. Keep the bottle on a firm surface.
  
  
• Open the clamp on the drainage tubing. This will start the flow of fluid.
  
  
• Drain as much fluid as directed. Do not drain more than 1000 mL of fluid from a chest catheter. Do not remove more than 2000 mL of fluid from an abdominal catheter. To make the fluid drain slower, roll the clamp toward the bottle or gently squeeze the clamp. To make the fluid drain faster, slide the clamp away from the bottle or slowly release the clamp. It is normal to feel pain or cough when fluid is drained. To decrease pain or coughing, slow down the flow of fluid. You can also close the clamp and take a break. If your symptoms do not get better when you stop draining, do not continue to drain fluid.
  
  
• Change the bottle when it is full. If you need to use a second bottle, close the clamp on the drainage tubing. This will stop fluid from draining. Hold the end of your catheter. Pull out the end of the drainage tubing from your catheter. Do not let the end of your catheter touch anything. Remove the cap on the end of the new drainage tubing. Insert the drainage tubing into your catheter. Remove the support clip on the bottle. Push down on the bottle plunger. Open the clamp on the drainage tubing. Continue to remove as much fluid as directed.
  
  
• Close the clamp on the drainage tubing to stop fluid from draining. Check that the clamp is completely closed.
  
  
• Pull out the end of the drainage tubing from your catheter. Do not let the end of your catheter touch anything.
  
  
• Clean the end of your catheter with a new alcohol pad. This will help prevent infection.
  
  
• Place the new cap over the end of your catheter. Twist it clockwise until you hear or feel a click.
  
  

What should I do after I drain fluid?

• Clean the skin around your catheter with a new alcohol pad. Start closest to where the catheter is inserted in your skin. Move the alcohol pad in circles away from your catheter.
  
  
• Place the foam pad around your catheter. The foam pad should have a small cut in it. This cut lets you fit the foam pad around your catheter.
  
  
• Loop the end of the catheter. Place the looped catheter on top of the foam pad. Hold it on top of the foam pad. Place the gauze from your procedure kit over the catheter. Make sure the catheter is completely covered by the gauze.
  
  
• Remove your gloves. This will make it easier to handle the clear sticky bandage.
  
  
• Place the sticky bandage over the gauze. There are 3 layers you need to remove from the bandage. Remove the larger white layer from the bandage. Place the bandage over your gauze so the gauze is in the center of the bandage. Hold one corner of the bandage and remove the larger clear layer of the bandage. Remove the last white layer of the bandage. Press gently on all corners of the bandage to help it stick to your skin.
  
  
• Write down the amount of fluid you drained. There are measurements on the side of the bottle. Also write down the color of the fluid, the date, and the time. Bring this record with you to your follow-up visits.
  
  
• Empty the fluid from the bottle. Hold the bottle steady with one hand. Push down on the plunger at the top of the bottle. Move the plunger in circles. Open the clamp on the drainage tubing for 10 seconds and then close it. Pull back the plunger. Push sideways and down on the side of the bottle cap to loosen it. Remove the drainage tubing from the bottle. Empty the bottle of fluid into the toilet.
  
  
• Place the drainage tubing and bottle in a sealable plastic bag. Throw the bag away with your regular garbage. Never recycle the plastic bottle.

What else do I need to know?

• If your catheter comes out, cover the opening in your skin with sterile gauze and a bandage. Use the sterile gauze and bandage from your drainage kit.
  
  
• Do not take a bath or swim in hot tubs or pools. This can cause an infection.
  
  
• You can shower or take a sponge bath. Make sure your bandage covers your catheter before you bathe. The edges of the bandage should make contact with your skin on all sides. This will prevent water from getting into your drain. If your bandage gets wet, remove the bandage. Clean your skin around the catheter and replace the bandage as directed.

What are the risks of a chest or abdominal catheter? Your catheter may move out of place or become blocked. Your catheter may cause an infection. Too much fluid may be drained from your abdomen or chest. This may cause you to feel lightheaded, dizzy, or weak. A catheter in your chest may cause your lung to collapse. This may cause trouble breathing and become life-threatening.

Call 911 or have someone else call for any of the following:

• You have trouble breathing.
  
  
• You faint or lose consciousness when you drain your catheter.

When should I seek immediate care?

• Your catheter comes out.
  
  
• You feel weak, dizzy, or faint.
  
  
• You have severe pain or shortness of breath when you drain fluid or after you stop draining.

When should I contact my healthcare provider?

• Your symptoms, such as pain or shortness of breath, do not get better after you drain fluid.
  
  
• You have redness, pain, or pus where the catheter is located.
  
  
• You have a fever.
  
  
• You cannot drain fluid.
  
  
• You see a change in the color of fluid that you drain.
  
  
• You see fluid leaking from around your catheter.
  
  
• You drain foul-smelling fluid or bloody fluid from your catheter.
  
  
• You see a hole or tear in your catheter and need to use the emergency clip.
  
  
• You have questions or concerns about your condition or care.

CARE AGREEMENT:

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