Tips for Managing Drains and Devices

Site care
1) Clean site daily and as needed to remove drainage from skin. Use sterile technique and sterile normal saline if indicated. Surgically placed drains and devices will generally require sterile technique - check with surgeon for preference.
If sterile technique is not required, site may be cleaned with a mild soap and water or pH balanced skin clincher.

2) if exposure to drainage is likely:
protect skin with an alcohol free barrier film.
Absorb drainage with a gauze sponge cut to fit around and/or under device or if copious drainage is noted, an ostomy pouching system may be indicated. Consult an ET nurse or wound specialist for assistance.

Stabilization,
1) secure the drain/device to prevent twisting, rotation and/or vertical movement within the site, this is especially important for gastrostomy tubes and wound drains. To do this, stabilize the tube or device near or at its exit site from skin. The following may be used:
specialized devices.
Tape
tape and ostomy barrier wafers.
Pouching systems.

2), Indwelling urinary catheters should be secured according to facility policy.

Long and/or heavy tubing should also be stabilized distally to prevent tugging and twisting. This is most often done by attaching the mid-or distal portion of the tube to the patients down or clothing with tape or a tape tab and a safety pin.

Complications,
1) report the following:
    a) an increase or decrease in drainage outside the expected range of normal.
    b) tube or device is dislodged or increased length is noted.
    c) drainage becomes purulent and/or develops a foul odor.
    d) erythema develops or increases in surrounding skin.
    e) induration (hardness) develops or increases in surrounding skin.
    f) patient complains of new or increasing discomfort.

Consult ET nurse or nurse specialist for assistance with tube/device management.