Ocean™ Water
Seal Drain FAQ
The following questions may be often asked about
the Ocean drains, and the answers are provided here for your convenience.
If you have further questions, please contact
our 24-hour technical support.
- Should the suction control
stopcock be turned off for gravity drainage or for patient
transport?
- How do I confirm the patient
has a pneumothorax?
- If the chest drainage system
has been knocked over, can I use it and what should I do?
- How do I lower the water
seal column?
- Is it normal for the patient
pressure float ball to fluctuate up and down (otherwise known
as ‘tidaling’) near the bottom of the water seal
column?
- How do I sample patient
drainage or add anti-coagulant?
- Is the Ocean drain MRI compatible?
- How do I set up the Ocean
drain for “balanced drainage” for pneumonectomy
patients?
- Does the Ocean drain contain
any latex?
- How do I dispose of the
system?
- How do I impose suction pressure greater than -20cmH20
with the Ocean Series Drain?
1. Should the suction
control stopcock be turned off for gravity drainage or for patient
transport?
No. The suction control stopcock should always remain in the on position
when connected to the patient. If the stopcock is turned off though,
the patient is still protected two ways; first by the one-way valve created
by the water seal, and second, by the integral positive pressure valve.
Both the water seal and the positive pressure valve provide maximum patient
protection when either the suction line or stopcock remain open or closed.
It is not necessary to turn off the stopcock, clamp, or cap the suction
line during gravity drainage or patient transport. Return
to Top
2. How do I confirm
the 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. 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. If bubbling is
present (constant or intermittent) in the water seal air leak monitor,
this will confirm an air leak is present. Return to Top
3. If the chest drainage
system has been knocked over, can I use it and what should I
do?
After a chest drainage system has been knocked over, set it upright and
immediately check the fluid levels of the water seal and suction control
chamber for proper volumes. If the fluid levels need to be altered, Atrium
provides convenient access for fluid adjustment by providing self-sealing
diaphragms that can be accessed with a 20 gauge or smaller needle and
syringe. If the water seal has an inadequate fluid level, simply replace
the lost volume. If a significant amount of fluid has entered the water
seal, it may be advisable to change the system for a new one. Return
to Top
4. How do I lower the
water seal column?
Changes in your patient’s intrathoracic pressure will be reflected
by the height of the water in the water seal column. These changes are
usually due to mechanical means such as milking and stripping patient
drainage tubes, or simply by deep inspiration by your patient after all
air leaks have subsided. If desired, the height of the water column and
patient pressure can be reduced by temporarily depressing the filtered
manual vent, located on top of the drain, until the float valve releases
and the water column lowers to the desired level. Do not lower water
seal column when suction is not operating or when patient is on gravity
drainage. Return to Top
5. Is it normal for
the patient pressure float ball to fluctuate up and down (otherwise
known as ‘tidaling’) near the bottom of the water
seal column?
Yes. Once your patient’s air leak is resolved, you will generally
observe moderate tidaling in the water seal column. Increases in intrathoracic
pressure will cause the water level to rise (the ball rises) during patient
inspiration and will lower or decrease (the ball drops) during patient
expiration. This diagnostic tool will help to confirm patency of your
patient’s catheter(s). Minor “bouncing” of the water
seal level can also be caused by vigorous bubbling of the suction control
chamber. To accurately assess patient catheter patency, momentarily occlude
suction to stop the suction control chamber from bubbling and observe
the water seal’s physiological response. Return
to Top
6. How do I sample patient
drainage or add anti-coagulant?
Most users rarely utilized the grommet on the front of the drain because
the patient sample would not be fresh. Also, most prefer to inject anti-coagulant
into the filter to aid in clot reduction. If you wish to sample patient
drainage or add anti-coagulant to the collection chamber, samples can
be taken directly from or added through the patient tube by inserting
a 20 gauge or smaller needle with syringe in accordance with approved
hospital guidelines. Alternately, Atrium’s needleless adapter kit
(Code No. 19921) may be purchased separately and used on an as needed
basis. Return to Top
7. Is the Ocean drain
MRI compatible?
The metal contained within the drain 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
8. How do I set up the
Ocean drain for “balanced drainage” for pneumonectomy
patients?
With balanced pneumonectomy drainage no suction is connected and the
suction control stopcock should remain open. Also the suction control
chamber does not need to be filled. The water seal is filled to the 1cm
level, instead of the normal 2cm. The depth of the water in the water
seal determines the maximum amount of positive pressure in the chest.
With a 1cm water seal, the maximum amount of positive pressure is +1cmH2O.
With a 1cm water seal, pleural negativity can not exceed approximately
-17cmH2O. If patient intrathoracic pressure begins to increase to approximately
-17cmH2O, air at a lesser negative pressure will pass through the water
seal and enter the pleural space. This will reduce the negative pressure
in the pleural space.
Set up:
1. No suction is connected and keep stopcock
open
2. The suction control chamber should not be filled
3. The water seal is filled to just below the 1cm level, as opposed to
the usual 2cm level, since the depth of the water in the water seal determines
the maximum amount of positive pressure in the chest. With approximately
1cm water seal, pleural negativity cannot exceed approximately -17cmH2O,
air at a lesser negative pressure will pass through the water seal.
Return to Top
9 Does the Ocean drain
contain any latex?
The Ocean 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
10. 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 stopcock be turned to the off
position and the patient line occluded using the blue slide clamp provided
with each drain. Return to Top
11.
How do I impose suction pressure greater than -20cmH20 with the
Ocean Series Drain?
Suction greater than -20cmH20 can be imposed by taping over the grey vent plug
with non-porous tape and reading vacuum pressure directly from the regulator.
See link for conversion table.
Table
Ocean Series Vent Plug / Conversion Chart
(PDF)
Photo of Green Vent Plug
Return
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