Express™ Dry
Seal Drain FAQ
The following questions may be often asked about
the Express drain, and the answers are provided here for your convenience.
If you have further questions, please contact
our 24-hour technical support.
- Is it required to fill the
air leak monitor?
- What does it mean when the
vacuum indicator is visible?
- When will I see a rise in
the air leak monitor column?
- Should the manual vent be
used during gravity drainage?
- What should I do when the
suction monitor bellows is not expanded to the [delta symbol]
mark when the regulator is set at -20cmH2O or higher?
- What should I do when the
bellows does not fully expand to the [delta symbol] mark
after I increase the suction source vacuum?
- Does the bellows need to
expand beyond the [delta symbol] mark for a -10cmH2O regulator
setting?
- How do I confirm my patient
has a pneumothorax?
- What does it mean when the
small float ball is located at the bottom of the air leak
monitor?
- What should I do if the
chest drain gets knocked over?
- If the regulator of the
Express is set at -20cmH2O (preset level), how do I know
my patient is experiencing -20cmH2O?
- Does the Express drain
contain any latex?
- Is the Express drain MRI
compatible?
- How do I dispose of the
system?
1. Is it required to
fill the air leak monitor?
It is not required to fill the air leak monitor for seal protection.
However, the air leak monitor should be filled for confirmation and detection
of air leaks.
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2. What does it mean
when the vacuum indicator is visible?
The [check mark symbol] indicates that there is vacuum present in the
system (negative pressure, i.e. -20cmH2O). When vacuum is not present
(atmospheric pressure) no symbol will appear. All patient tube connections
and the vacuum indicator window should be checked regularly for vacuum
confirmation. Return to Top
3. When will I see a
rise in the air leak monitor column?
A rise in the air leak monitor column will only be seen if there is an
increase in negative pressure on the patient side. When changing suction
pressure from a higher level to lower level, depress the manual high
negativity vent to reduce excess vacuum to the lower prescribed level. Return
to Top
4. Should the manual
vent be used during gravity drainage?
No. It is not recommended to depress the manual vent during gravity (no
suction) drainage. Depressing the manual vent during gravity drainage
could potentially result in positive pressure (atmospheric air) getting
back to the patient. Return to Top
5. What should I do
when the suction monitor bellows is not expanded to the [delta
symbol] mark when the regulator is set at -20cmH2O or higher?
The position of the bellows across the suction monitor window will alert
the operator that the suction source has fallen below the minimum operating
range for the prescribed suction control setting. Simply increase the
vacuum source to -80mmHg or higher. The suction monitor bellows must
expand to the [delta symbol] mark or beyond for a -20cmH2O or higher
suction regulator setting. Return to Top
6. What should I do
when the bellows does not fully expand to the [delta symbol]
mark after I increase the suction source vacuum?
Dry suction chest drains require higher levels of vacuum pressure and
air flow from the suction source to operate efficiently at each suction
control setting as compared to traditional water controlled operating
systems. The suction source should provide a minimum vacuum pressure
of -80mmHg at 20 liters of air flow per minute for chest drain operating
efficiency at a suction control setting of -20cmH2O. The suction source
should be greater than -80mmHg when multiple chest drains are connected
to a single suction source. If the bellows does not fully expand to the
[delta symbol] mark, it may simply be that the suction source is not
functioning to its full potential to provide the minimum vacuum pressure
or air flow required to “drive” the suction control regulator.
Additionally, conditions may exist that can reduce, or “restrict” air
flow from the suction source. A restrictive clamp, connector, or kink
in the suction line tubing can potentially “starve” the chest
drain of air flow. A leak in a connection or wall canister, along with
extensive lengths of suction tubing can also reduce air flow to the unit.
To troubleshoot this situation, first check to
be sure that all connections are air-tight. Inspect the suction
tubing and connections for possible cracks, leaks, kinks, or occlusions.
You may need to simply bypass a “leaky” wall canister.
Try connecting the chest drain to a different suction source or
wall regulator. When multiple chest drains are “Y” connected
to a single suction source, if possible, reconnect the drains to
separate suction sources. Finally, replace the chest drain if you
suspect the unit is cracked or damaged.
Return to Top
7. Does the bellows
need to expand beyond the [delta symbol] mark for a -10cmH2O
regulator setting?
No. For a regulator setting less than -20cmH2O suction (-10cmH2O), any
observed bellows expansion across the monitor window will confirm suction
operation. The bellows need not be expanded to the [delta symbol] mark
for suction pressures less than -20cmH2O, just visibly expanded to confirm
suction operation. Return to Top
8. How do I confirm
my patient has a pneumothorax?
If there are no air bubbles observed going from right to left in the
water seal, there is no patient air leak. If bubbling is present (constant
or intermittent) in the water seal air leak monitor, this will confirm
an air leak is present. In order to confirm that your patient’s
chest catheter(s) are patent, temporarily turn suction off and check
for oscillation of the patient pressure float ball in the water seal
column coinciding with patient respiration.
Return to Top
9. What does it mean
when the small float ball is located at the bottom of the air
leak monitor?
If the small float ball is located and oscillating at the bottom of the
air leak monitor with no bubbling, there is no apparent patient air leak.
However, the air leak monitor should be carefully monitored for the presence
of an occasional or intermittent air leak.
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10. What should
I do if the chest drain gets knocked over?
We recommend that the drain be placed back into the upright position;
however it will continue operating if knocked over. After the drain is
set upright, check the fluid level in the air leak monitor. Atrium provided
a convenient needleless luer port on the back of the Express drain to
adjust the fluid level. Simply use a syringe (no needle) to add or remove
fluid in the air leak monitor, if required.
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11.
If the regulator of the Express is set at -20cmH2O (preset
level), how do I know my patient is experiencing -20cmH2O?
With the dry suction regulator there is a small amount of variance in
suction at any given suction level. That variance is +/- 2cmH2O. That
means if the regulator is set at -20cmH2O then the patient could be experiencing
anywhere from -18cmH2O to -22cmH2O. That is a small amount of variance
and not clinically dangerous for the patient. Atrium’s dry suction
regulator are pre-assembled and tested before being added to each drain.
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12.
Does the Express drain contain any latex?
The Express series chest drains do not contain natural rubber latex (NRL)
or dry natural rubber (DNR) and bear labeling with the ‘LF’ symbol
and the statement “Latex Free”. Return to
Top
13.
Is the Express drain MRI compatible?
The metal contained within the drain (small spring for manual vent) is
stainless steel which is non-magnetic. The metallic material used in
Atrium Medical Corporation’s chest drainage units will have no
effect on the MRI equipment. This will allow for the product to remain
attached to the patient while the MRI is being performed. Return
to Top
14.
How do I dispose of the system?
Disposal of system and contents must be in accordance with approved hospital
infection control standards. To minimize the possibility of fluid leaking
from the drain, it is suggested that the patient line occluded using
the blue slide clamp provided with each drain. Return
to Top
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