When using a small-bore catheter with a one-way valve such as a ...

[kwoodring]

When using a small-bore catheter with a one-way valve such as a Heimlich valve, how can you determine definitively that there is or is not a small air leak?
 
  a. Connect to an underwater seal.
  b. Increase the FiO2 and note clinical chang-es.
  c. Listen for air movement.
  d. Watch the valve to see if it moves.

Question 2

What are the functions of a chest tube in a patient with chest trauma that causes bleeding and pneumothorax?
 
  1. To measure the rate of bleeding
  2. To improve ventilation
  3. To allow lung reexpansion
  4. To allow for application of bleeding control medication
  a. 1 and 4 only
  b. 2 and 3 only
  c. 4 only
  d. 1, 2, and 3 only

[cswans24]

Answer to Question 1

ANS: A
It is difficult to determine whether a Heimlich valve has an ongoing leak unless it is placed to underwater seal. This procedure can be done in the emergency department by placing the Heim-lich valve into a cup of water or by placing it in-line with a water-seal chamber to see whether an air leak is continuing after lung expansion.

Answer to Question 2

ANS: D
The chest tube is multifunctional to allow measurement of the rate of bleeding, to allow the lung to be pulled to the parietal pleural surface to tamponade bleeding, and to allow maximum venti-lation.