Percutaneous PleurX drainage catheter

Daily Drain Care Task Checklist

• Inspect the catheter every day.
• Drain fluid from the pleural space as often as directed by your provider. Document amount of fluid drained and upload pictures of the fluid on your MDC account.
• Change your dressing regularly, at least once a week.

Inspecting the PleurX Catheter

1. Check the dressing. If it is wet, dirty, loose, or coming off the skin then it needs to be changed. (link to Changing the Dressing/Skin Care)
2. Check for kinks in the catheter. Straighten it if necessary.
3. Check if the catheter is broken, damaged, or cut. If it is: push a blue emergency slide clamp on the catheter until it is pinched down or bend the catheter at a position before the damaged portion and tape it down. Call your provider right away.

How to Drain Your PleurX Catheter

Follow your provider's orders on how often you should drain your PleurX catheter. Do not drain more than 1000 mL unless told by your provider. Every time you drain your PleurX catheter, enter these values into your MDC account:

• Date and time
• Amount of fluid drained
• Picture of the fluid
• Any abnormal symptoms

Steps for draining the PleurX catheter

1. Obtain a PleurX drainage kit which includes: 1 vacuum bottle, 1 self adhesive dressing, 1 pair of medical gloves, 3 alcohol wipes, 1 valve replacement cap, 4 square gauze pads, 1 foam catheter pad, 1 emergency clamp (only use the emergency clamp if the catheter is broken or leaking). (hyperlink here to our store for PleurX drainage kit)
2. Wash your hands with soap and water.
3. Consider changing your dressing (Changing the Dressing/Skin Care hyperlink).
4. Open the PleurX drainage kit and remove the procedure pack.
5. Spread open the blue wrapping in the PleurX Procedure Pack so you can see all the supplies. If you are only draining your catheter, you will only use the alcohol wipes and valve replacement cap. The other materials are for if you want to also change the dressing

6. Take out the vacuum bottle and make sure the hard plastic access tip is covered with a soft plastic sleeve. The plastic sleeve keeps the tip clean while you are setting up. If the sleeve is missing, start over with a new drainage kit.

   

7. Set the vacuum bottle near the blue wrap. Take off the paper holding the drainage line. Place the access tip on the blue wrap.
8. Put on medical gloves.
9. Open the 3 alcohol pads but don’t remove the pads. Place these on the blue wrap.

10. Close the roller clamp on the drainage line by rolling the wheel towards the drainage bottle.

    
11. Remove the plastic cover from the access tip and set the access tip back on the blue wrap.

12. Pick up the end of your PleurX catheter and hold it away from your body. Twist off the valve cap and throw it away. Make sure the valve doesn’t touch anything.

    
13. Use an alcohol wipe to clean the valve then throw the wipe away. Keep holding the catheter away from your body making sure it doesn’t touch anything.

14. Push the access tip of the drainage line into the clean catheter valve. You will feel a snap

    

15. Remove the support clip beneath the T plunger of the vacuum bottle.

    

16. Push the T plunger down to puncture the seal which activates the vacuum in the bottle.

    

17. Slowly roll the wheel on the roller clamp away from the bottle to release the clamp. Pleural fluid should start flowing into the drainage line.

    
18. When fluid starts to flow, you can roll the clamp to adjust the flow of fluid. If you feel pain or start to cough, slow down the flow of fluid or stop immediately.
19. When the flow stops or the bottle is filled, close the roller camp by rolling the wheel towards the bottle. If you were instructed to drain more fluid than the bottle can hold, disconnect the vacuum bottle as described in the steps below and connect a new vacuum bottle.
20. Ensure the roller clamp is closed and disconnect the access tip out of the valve. Set the access tip down and keep holding the catheter away from your body. If you are connecting a second drainage bottle, clean the catheter valve and follow the steps on how to connect another bottle as you did on the steps above.
21. Once you are done draining and have disconnected the drainage line, use an alcohol wipe to clean the valve for 15 seconds.

22. Next put on the replacement valve cap over the clean catheter valve and twist until it is locked into position.

    
23. Next you need to empty the vacuum drainage bottles and throw them away.
24. Make sure the clamp on the vacuum drainage bottle is tightly cosed.
25. Remove the top part of the bottle and remove the bottle opener from the drainage line by squeezing the flexible cap and pulling the bottle opener off.
26. Empty the drainage contents into the toilet.
27. Place the drainage bottle and tubing in a sealed plastic bag and throw it away.

Changing the Dressing/Skin Care

1. Gather your supplies: 1 alcohol pad, 4 square gauze pads, 1 foam catheter pad, 1 self adhesive dressing with 3 layers, 2 pairs of medical gloves, and a trash can.
2. Wash your hands with soap and water
3. Put on a pair of medical gloves. Gently remove the clear dressing and gauze over the catheter and the foam pad underneath the catheter. Throw them awa.
4. Take the medical gloves off and wash your hands with soap and water.
5. Use an alcohol pad to clean the skin around the catheter and the catheter itself.
6. Inspect the skin and make sure there is no redness, skin irritation, or leaking fluid. Make sure the catheter is not broken.
7. Let the skin dry for 30 seconds.

8. Once, the skin is dry, place the new foam pad under the catheter and position the catheter on top of the foam pad.

   
9. Place the new gauze pad over the catheter and foam pad. If possible, you can hold this gauze pad in place while your caretaker does the next steps.
10. Take off the medical gloves.
11. Peel the printed liner off the self adhesive dressing. Center the self adhesive dressing over the gauze pads and press down over your skin.

12. Peel off the paper center panel and frame on the self adhesive dressing. Press the dressing down onto the skin. Throw the paper center panel and frame away.

    
13. Wash your hands.

Nothing is draining from my catheter

Make sure the T plunger at the top of the vacuum bottle is pushed all the way down. Make sure the drainage line is securely connected to the PleurX catheter valve. Make sure the roller clamp on the drainage line is open. Make sure there are no kinks in your catheter. Roll the PleurX catheter between your fingers as this may loosen any blockages. If these steps don’t work, try a new PleurX drainage kit. If fluid is still not draining, there may not be enough fluid in your pleural space to drain.

How often should I drain the pleural fluid?

As directed by your provider which is usually every 1-2 days. Talk to your provider before changing the frequency.

What if the volume of my drainage changes?

If you try to drain fluid three times in a row and each time is less than 50 mL, you should see your provider to see if the catheter needs to be removed or replaced.

How long will the catheter remain in my chest?

The catheter remains in your chest for as long as you need until fluid stops draining. This amount of time varies from patient to patient.

What if the fluid color changes?

Take a picture and upload the fluid color to your MDC account.

What if the catheter is pulled out?

Cover the exit site with a sterile dressing and call your provider.

Signs of infection

If there is pain, redness, warmth, swelling, abnormal discharge near the catheter site, or you have a fever, this may indicate that your catheter is infected. Call your provider immediately if you experience these symptoms.

Call your doctor and seek immediate medical care if you notice the following signs and symptoms:

• Signs of infection
  • Increase pain, swelling, warmth, redness around drain site
  • Pus draining from the insertion site
  • Fever
• Sudden change in color and smell of your drainage
• Tube is coming loose out of your insertion site