Chest closure in ICU
Clinical Procedure
 
Aliases:
Closing the chest in ICU

Topic aliases are alternate phrasings for a particular topic.


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Check the CXR and ensure the tip of the ETT is not positioned too high as the neck will be extended with a shoulder roll resulting in some withdrawal of the ETT

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Investigations to check:

Ensure Hb > 140g/dL
Platelet count adequate
Electrolytes normal
Coags normal

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Check all your lines to make sure they are patent before draping the patient.

Once the patient is draped accessing the lines to troubleshoot will be very difficult.

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Ensure at least two good lines are available, including one volume line.

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Ensure all your pressure lines are correctly levelled, zeroed and are giving you the expected pressure trace before draping.

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Muscle relaxant immediately prior to the procedure and administered appropriately throughout the case

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Single dose antibiotic prophylaxis prior to procedure.

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Fentanyl 2mcg/kg plus or minus morphine 200mcg/kg boluses titrated to haemodynamics

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Ensure blood is available in the room

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