Pigtail Catheter PDF

Pigtail Catheter Developed by Tiara Healy – CNE Community Health Services October 2024  A closed and passive drain Inserted under Ultrasound or with CT guidance to drain a collection Used for drainage of abscesses, bile and urine...

Pigtail Catheter Developed by Tiara Healy – CNE Community Health Services October 2024  A closed and passive drain Inserted under Ultrasound or with CT guidance to drain a collection Used for drainage of abscesses, bile and urine Called pigtail due to the shape of the tip of the drain which holds it in place Overview internally Pigtail catheters are coiled after insertion using an internal string in the lumen, which is locked into place at the external end of the drain Connected to a drainage bag or covered by a transparent drainage pouch May have a 3-way tap applied to maintain a closed system Basics of Interve ntional Radiology : Pigtail Drainage Catheters (youtu be.com) Placement of a Pigtail Cathe ter (youtube.c om) Securement Held in place by a stat-lock or drain fixating device. The StatLock™ CV Plus Stabilisation Device is a "post and door" design to house the suture wings, along with a "pigtail" pad to retain and organise the catheter lumens.  Measurement At the first dressing/ StatLock® change and subsequent changes measure the length of exposed tube from the insertion site to the base of the hub and compare with the original measurement recorded in the patient’s clinical record.  Dressing Changes Golden rule for dressing changes is a week or a leak Check the dressing over the catheter exit site each visit - If it’s wet, dirty, loose, or has started to lift from the skin, change it Do not reinforce the dressing – change it. Dressing changes allows for a full assessment of the catheter exit site. Check for signs of infection, areas of broken skin, rash or leaking fluid Document dressing changes on DMR Procedure – reference draft protocol  Removal Surgical drains should be removed as soon as they are no longer required Generally, drains are removed if they have drained less than 25mls in 24 hours (1ml/hr) Ensure that you have a documented medical order to remove a drain prior to its removal Procedure – reference draft protocol Pigtail can only be removed once internal string (black suture) inside device is cut which extends tubing allowing for removal without trauma  Flushing & Aspirating May require flushing or flushing AND aspirating to assist with patency o MO order required o Pulsatile technique flush o Slow and gentle aspiration The frequency, type of fluid, amount of fluid to flush and whether it is a flush only or flushing and aspirating need to be recorded by the MO in the National Inpatient Medication Chart and/or documented in the client’s progress notes Flushing/Removal pigtail catheters flushing and removing – YouTube How to remove a locking pigtail drain. (youtube.com)  Document in: o patient’s progress notes o fluid balance chart o (if applicable) the wound management plan Note: o colour o amount of drainage Documentation o patency of the drain tube o dressing changes required o any variations to the insertion site appearance 24 hour output recorded on the fluid balance chart Any changes in drainage output (including unexpected increase in output and change in type or colour of drainage) must be reported to the MO and to the nurse in charge and documented clearly The medical/surgical team are required to document the initial drain orders and any changes in treatment in the patients progress notes. E.g. when a drain tube is to be removed, flushed, aspirated, or any other variations to the current management of the drain Notify the MO/Specialist/Registrar immediately if: The patient reports pain or there is difficulty with flushing/aspirating the drain (only those permitted to be flushed) There is leakage around the drain insertion site (light drainage may occur for the first 1 to 3 days after drain insertion) There is inflammation, swelling or purulent discharge around the drain insertion site The drain has moved more than 2 cm or has been dislodged The patient reports experiencing nausea, vomiting, fever, chills, or weakness Troubleshooting Problem Intervention Rationale Drainage is more than 300mls in 24 hours Complete a set of vital signs and respond appropriately A large volume of drainage can Inspect the wound/drain site indicate the patient is actively bleeding Contact surgical team for plan Drainage colour changes from Complete a set of vital signs and respond to appropriately The fluid should change gradually from blood to a haemoserous haemoserous to frank blood coloured fluid as the patient recovers Contact surgical team for plan Frank blood can indicate the patient is actively bleeding Drainage suddenly stops Check drain tubing is not kinked or clamped, the drain is intact, vacuum is Wound drainage should decrease still present and the drain remains in situ. slowly not suddenly as the patient recovers Notify surgical team for plan Drain is difficult to remove or not intact on Cover wound site with an The drain maybe entangled removal occlusive dressing, keep patient RIB, contact surgical team and send to hospital for around or broken around anatomical structures xray and management Increase redness /swelling around the insertion Mark redness or swelling with a pen to establish a base line and continue to Micro-organisms can travel into site monitor the drain site Notify surgical team for review of the drain, swab of wound site and review of antibiotic therapy Excessive discharge from drain site post Monitor discharge by marking theoutline on the dressing with a pen and write Large amounts of discharge from removal the time of the marking to facilitate easy monitoring wound post removal could indicate fluid remaining, tracking of the wound If large amounts of discharge persist. Notify surgical team and cover wound under the skin or haematoma site with a drainage bag. Record discharge on a fluid balance chart Resources How to Care for a Pigtail Drain - Together by St. Jude™ (s tjude.org) Nursing guidelines : Surgical drains (non cardiac) (rch.or g.au) https://www.canberrahealthservices.act.gov.au/__data/a ssets/word_doc/0007/1981285/Drain-Management-2.doc x