Assessment the nurses performance in providing care to patients undergoing chest tube in Suez Canal university hospital

Chest tube care is one of the most important nursing procedures because patients who need chest tubes are usually seriously ill and require advanced nursing care. Accordingly, vigilant and expert nursing care can prevent serious complications. The aim of the present study is to assess nurses' performance in providing care to patients undergoing chest tube. The study was a descriptive research design was used to conduct this study; a total number of 70 nurses were selected randomly using systematic sampling technique. Data were collected for a period of four months, using two tools: Tool [1] Questionnaire sheets to assess nurses, knowledge about care provided to patients undergoing chest tube. Tool [2]: Observational checklist to assess the nurses' practice in providing care to patients undergoing chest tube. The results of the present study revealed that unsatisfactory level of performance in providing care to patients undergoing chest tube among nurses in the sample. There was significant relation between nurses, knowledge, practice and degree of qualification. Also there was no correlation between nurses, knowledge and practice .The study recommended that improve nurses, theoretical knowledge and clinical applications of chest tube care and continuous evaluation of nurse's knowledge and performance is essential to identify nurse's needs

Procedimientos quirúrgicos en 156 casos de derrame pleural: resultados inmediatos / Surgical procedures in 156 cases of pleural effusion: immediate results

Introducción: el derrame pleural es una entidad clínica frecuente, su estudio y manejo son importantes para resolverlo. El objetivo fue evaluar los resultados inmediatos de los procedimientos diagnósticos y terapéuticos en casos consecutivos de derrame pleural. Material y métodos: durante un periodo de 12 meses, de 787 pacientes hospitalizados, 156 (19.8 %) presentaron derrame pleural. También se evaluaron 22 casos de neumotórax considerados como derrame gaseoso y 10 con empiema crónico. Resultados y discusión: en 23 casos no neoplásicos, la toracentesis diagnóstica y evacuadora resolvió el derrame. El drenaje con sonda intrapleural conectada a sello de agua se practicó en 133: en 109 (81.9 %) se resolvió el derrame y en 24 se practicaron otros procedimientos. En este grupo el derrame fue neoplásico en 35 y no neoplásico en 98, incluidos 36 iatrogénicos; 22 casos de neumotórax se consideraron como derrame gaseoso y fueron tratados con sonda intrapleural; 10 casos de empiema crónico fueron estudiados como secuelas de derrames, no fueron resueltos con los procedimientos mencionados. Hubo diferencia significativa entre derrames neoplásicos y no neoplásicos (p = 0.001), y entre casos manejados con procedimientos de invasión mínima y sonda intrapleural (p = 0.001), por comparación de proporciones. Se comenta la utilidad de la pleurodesis y la toracoscopia en el tratamiento del derrame. En casos crónicos la toracostomía en ventana y mioplastia consecutiva tienen indicación precisa. Conclusiones: el diagnóstico y tratamiento oportunos del derrame pleural son importantes. La colocación de sonda pleural resuelve la mayoría de los casos (89.9 %). El neumotórax debe ser igualmente manejado. El empiema crónico requiere toracostomía en ventana y mioplastia. Las maniobras descuidadas o inadecuadas provocan derrames de naturaleza iatrogénica.

BACKGROUND: Pleural effusion is a common clinical entity. Proper diagnosis and management are important for successful treatment. We undertook this study to evaluate immediate results of the procedures used in a group of cases with pleural effusion. METHODS: Of 2589 patients at first consultation, 787 were hospitalized and 156 had pleural effusion. Diagnostic and therapeutic procedures used were evaluated. RESULTS: With thoracentesis and evacuation of liquid, 23 nonneoplastic cases had resolution. Chest tube drainage with water seal was performed in 133 patients. This procedure suppressed the effusion in 109 patients, but in 24 patients another approach was necessary. In this group there were 35 neoplastic and 96 nonmalignant cases, the latter 36 were provoked by iatrogenic management. Twenty two cases of pneumothorax considered as gaseous effusion and 10 cases of chronic empyema sequelae of pleural effusions were also studied. Proportion comparison demonstrated significant differences between neoplastic and nonneoplastic effusions (p =0.001) and in cases managed with minimally invasive procedures and chest tube drainage (p =0.001). The performance of pleurodesis and thoracoscopy is discussed. In chronic cases, indications of open window thoracostomy and myoplasty are elucidated. CONCLUSIONS: In pleural effusion, opportune diagnosis and proper management are essential. Drainage tube can solve the majority of cases. Pneumothorax must be treated in the same way. In chronic empyema, open window thoracostomy and myoplasty are indicated. Careless patient management and poor treatment lead to iatrogenic complications.

Central catheter induced pleural effusion: a case report

Pleural effusion is a rare complication of central catheter insertion. This may occur due to mispositioning of the catheter. We present a 74 year-old severely ill Iranian patient who underwent transhiatal esophagectomy because of esophageal carcinoma. After anesthesia induction, a catheter was inserted in right jugular vein. Postoperative radiography revealed right-sided pleural effusion that was managed with a chest tube. During the following days, the patient secreted two liter of a yellow fluid. Fluid analysis failed to show any remarkable results. His secretion was discontinued after the catheter was removed