Chest tubes are used in children for a number of different reasons. A chest tube is a tube that is placed through the skin into the chest cavity that can remove air, blood, or fluid out of the chest so your child can breathe better. Your child may need a chest tube for:
- an injury to the chest
- surgery on the heart or lungs
- an infection in the chest
- lung problems at birth
Placement
If your child has surgery, the tube will probably be placed while he / she is in the operating room asleep. But chest tubes may also be placed in the Emergency Department, at your child's bedside, or in Interventional Radiology.
Your child will be given pain medication before the tube is inserted. The doctor will need to make a small cut in the skin to insert the tube and once it's in place, he / she will add a small stitch to keep the tube from accidentally being pulled.
A dressing will be placed over the insertion site to keep it clean. Your child will need a chest x-ray after the tube is placed to make sure it is in good position.
Interventional Radiology Placement
Some children have their chest tube placed in Interventional Radiology. If that is the case, you and your child will meet the interventional radiologist and nurse who will explain the procedure and discuss the sedation medications that will be given to your child during the procedure to make your child comfortable.
Sometimes general anesthesia is given for placement. This would be up to your doctor and the interventional radiologist.
The chest tube will be placed in the Interventional Radiology suite using image guidance such as fluoroscopy (moving x-ray) and / or ultrasound. The interventional radiologist uses image guidance to view inside the body during the procedure.
After the interventional radiologist examines the area, he / she will need to make a small cut in the skin to insert the tube and once it's in place, he / she will add a small stitch to keep the tube from accidentally being pulled. There will be a dressing placed over the insertion site to keep it clean.
After the Procedure
After the tube is placed, it will be connected to a drainage container that will be placed on the floor. It may be placed to a continuous suction that makes bubbling sounds in water in the container.
After all the air, blood or fluid is removed from your child's chest and your doctor feels it is safe, the tube will be removed.
Your child will be given some pain medication before the tube is removed. The tube is generally removed at the bedside. Most children will have an x-ray after the tube is removed to make sure their lungs are still working well.
After the tube is pulled out, a dressing will be placed over the site to keep any air from getting into the chest. The dressing should remain in place for 48 hours.
After about 2 days, the dressing can be removed and a Band-Aid" can be applied. Once a scab has formed, the area should be left open to the air to help speed healing. At this time, your child can shower but should not bathe until the site is completely covered by a scab.
Diet and Activity
Your child will be able to eat as long as he / she doesn't have any other injuries or reasons not to. Most children are encouraged to get up and walk around to help their lungs heal faster. The doctor or nurse will let you know what type of activity your child should do.
When to Call the Doctor
Your child will be in the hospital until it is safe to remove his / her chest tube. However you should be aware of signs that your child is having difficulty breathing. Call your nurse if you notice:
- your child is grunting each time he / she breathes
- the skin between your child's ribs and on the neck sucks in with each breath
- your child's nostrils open wider to get more air
- your child complains of chest pain
- your child is breathing fast
- your child is very restless, crying or irritable
Written 2/03; revised 5/05, 5/07
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