View in context

16.8 Closed drainage systems: changing a vacuum bottle

This guideline is not to be used for underwater sealed drains (e.g. chest drains). See Chapter c12: Respiratory care, CPR and blood transfusion for such drains.

Essential equipment

  • Personal protective equipment
  • Dressing trolley or other suitable surface
  • Alcohol/chlorhexidine wipe
  • Sterile fluids for cleaning and/or irrigation, e.g. 0.9% sodium chloride
  • Vacuum drainage bottle, e.g. Redivac
  • Dressing pack, including sterile towel, gauze, gallipot and disposable bag
  • Gloves: one disposable pair, one sterile pair

Optional equipment

  • Any extra equipment that may be needed during the procedure, e.g. a clamp (although this is usually part of the drainage system in place) or hypoallergenic tape (to place on the side of the vacuum bottle to facilitate measurement of drain exudate)

Pre‐procedure

ActionRationale

  1. 1.
    Introduce yourself to the patient, explain and discuss the procedure with them, and gain their consent to proceed.
    To ensure that the patient feels at ease, understands the procedure and gives their valid consent (NMC [152], C; Walker [217], C).
  2. 2.
    Clean the trolley/tray and gather the equipment, checking the sterility and expiry date of the equipment and solutions, and place everything on the bottom of the trolley.
    To minimize the risk of infection (Loveday et al. [110], R).
  3. 3.
    Take the trolley/tray to the bed and adjust the bed to the correct height to avoid stooping.
    To promote good manual handling. E
  4. 4.
    Wash and dry hands thoroughly and put on apron and disposable gloves.
    To minimize the risk of infection (NHS England and NHSI [137], C).

Procedure

  1. 5.
    Remove the dressing pack from the outer pack and place it on the top of the clean dressing trolley/tray. Using aseptic technique, open the packaging of the other equipment required during the procedure (sterile gloves, vacuum bottle, etc.) and place the contents onto the sterile field of the opened dressing pack.
    To minimize the risk of infection (Fraise and Bradley [64], E).
  2. 6.
    Clean hands with an alcohol‐based handrub.
    To prevent cross‐contamination (NHS England and NHSI [137], C).
  3. 7.
    Seal off the bottle by closing both sliding clamps on the drainage tubing leading from the patient and the bottle connector.
    To prevent air and contamination entering the wound via the drain and to maintain the vacuum. E
  4. 8.
    Put on sterile gloves and, using a non‐touch technique, place the sterile field/towel under the drain tubing at the connection point between the vacuum bottle and drain tubing.
    To minimize the risk of infection (Loveday et al. [110], R).
  5. 9.
    Disconnect the bottle by unscrewing the Luer‐Lok, clean the end of the tube with an alcohol/chlorhexidine wipe and securely screw the new sterile bottle into the connecting tube at the Luer‐Lok.
    To maintain sterility. E
  6. 10.
    Unclamp both tubing clamps. Suction is established if the concertina bung remains compressed.
    To re‐establish the drainage system. E
  7. 11.
    The vacuum bottle should not be placed on the floor but placed below the level of the wound to allow drainage.
    To ensure continuity of drainage. Ineffective drainage can result in oedema or haematoma. To minimize the risk of cross‐infection (Hess [78], E).

Post‐procedure

  1. 12.
    Measure the contents of the used drainage system and record any additional drainage in the appropriate documents.
    To maintain an accurate record of drainage from the wound (NMC [152], C).
  2. 13.
    Place the used vacuum drainage system into the clinical waste bag and dispose of it according to local trust policy.
    To safely dispose of the used system. E
  3. 14.
    Document in patient's notes that the vacuum bottle has been changed.
    To ensure effective communication and instructions for ongoing care and accurate documentation of drainage (NMC [152], C).
View in context