Ambulatory Chest Tube Management: What Will They Think of Next?
Brenda Shelton, MS, RN, CCRN, AOCN Finksburg, MD sheltbr@jhmi.edu If someone had told me twenty years ago when I started in nursing that chest tubes could be managed as outpatients, I would have bet my next paycheck that it was impossible. Fortunately for patients, this innovation has become a reality, permitting patients with severe and recurrent pleural effusions to be managed in ambulatory and homecare settings. A large number of patients qualifying for this type of intervention are those with cancer-related pleural effusions (Ponn, Silverman, & Federico, 1997). As a patient group, as many as 60% of all patients with cancer will develop pleural effusions during the course of their disease continuum, and many when the therapeutic goal is palliation of symptoms (Putnam, 2002; Reeder, 2001). Subpopulations, such as those with lung, breast, lymphoma, ovarian, mesothelioma, and gastrointestinal malignancies, have an even greater incidence (Pien, Gant, Washam, & Sterman, 2001; Putnam et a
