References
Nursing a canine patient with a pneumothorax — a patient care report
Abstract
This article will describe and evaluate the nursing care provided for a canine patient that had a chest drain in place due to a tension pneumothorax. It is evident that nursing a patient with a chest drain involves implementing and carrying out a number of nursing interventions to ensure a high standard of nursing care is maintained and to reduce the risk of any complications. The relevant nursing interventions included: pain management, management of the chest drain, preventing patient interference and observation of the patient for potential complications associated with the chest drain. Recommendations for future practice have been suggested and based on available literature, these include: implementation of a pain scoring assessment and changing the patient's thoracic bandage twice daily to allow earlier recognition of any signs of infection.
A pneumothorax occurs as a result of an opening in the chest wall or damage to the pulmonary parenchyma which causes air to enter the pleural space and is commonly due to trauma (Fuentes and Swift, 1998). A chest drain, also known as a thoracostomy tube or thoracic drain, may be used to manage patients with a pneumothorax (Halfacree, 2011). Day (2014) states that chest drains are indicated in situations including: pyothorax management, following thoracic surgery, if negative pressure is not attained following thoracocentesis and if repeated thoracocentesis is essential for ongoing pneumothorax management. The most common complications seen in patients with a chest drain are: infection, patient interference and iatrogenic pneumothorax (Day, 2014).
The patient presented after running into a stick which penetrated his thorax adjacent to the sternum.
On initial assessment the stick was clearly visible entering the patient's thoracic cavity. The patient was tachycardic (150 beats per minute), dyspnoeic (36 breaths per minute) and hyperthermic (39.3°C). He had a normal capillary refill time (<2 seconds), pale pink mucous membranes and was noted to be hypoxaemic with the the percentage of oxygenated haemoglobin (SpO2) at 80%.
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