Tuesday, April 14, 2009

Jackson Pratt Drain Care 101



I have been referring so much of this term " JP or Jackson Pratt " in my blog. The following information should help me and my family care for him. He have 3 JP's. One in the middle ( for the incession) 2nd is in the left upper thigh and 3rd is on the upper right buttocks.


So , what is JP? or Jackson Pratt drain
?

A Jackson Pratt drain, or JP drain, is used to remove fluids that build up in areas of your body. Unwanted fluid can collect in areas of infection, areas where surgery has been done, or in other body areas. The JP drain is made up of a thin rubber tube and a soft round squeeze bulb. One end of the rubber tube is placed in the area where body fluids may build up. The other end sticks out of your body through a small incision (cut), and is connected to the squeeze bulb.

How does a Jackson Pratt drain work?

The JP drain removes fluids by creating suction (pulling) in the tube. To produce suction, the bulb is pressed flat and is connected to the tube sticking out of your body. Suction is created as the bulb sucks in air from the tube going into your body. This pulls fluid out from the area where the drain was placed and into the rubber tubing. The fluid then travels through the tubing and into the bulb of the JP drain. As the JP drain bulb fills with fluid, it goes back to its round shape.

Why do I need a Jackson Pratt drain?

When fluid builds up in a body area, the area may not heal as fast as it should, or an infection may start. Too much fluid in a body area may also cause pain and swelling. Using a JP drain after surgery may help you heal faster and decrease your risk of getting an infection. The JP drain also helps clear away pus and may help infections heal faster. A JP drain may be used after surgery on your spine to check if spinal fluid is leaking, and collect it. JP drains may also be used after skin flap surgery and skin grafting.

When is a Jackson Pratt drain removed?

The amount of fluid that comes out of the surgery or wound area and into the JP drain will decrease as the area heals. In most cases, the drain will need to stay in place until less than 30 milliliters (about two tablespoons) of fluid are draining from it in a day. Your caregiver will keep track of how much fluid is draining into the JP drain, and he will tell you when the drain will be taken out. If you are caring for your JP drain at home, you will need to keep track of the amount of fluid that you are emptying from the drain.

What are the risks of having a Jackson Pratt drain?

If a JP drain is not taken care of correctly, it may allow germs to enter your body and cause an infection. If the drain is placed after certain types of surgery, you may get an infection if it stays in your body longer than it is needed. If you get an infection, you may have more pain and swelling, and your wound will heal more slowly, or it may not heal at all. The end of the tubing inside your body may get blocked with blood or other materials. If this happens, the bulb cannot correctly suction fluids. You may develop a fistula (unwanted tunnel), or the drain may make a hole in your intestine. If you have a drain after skin flap or skin graft surgery, the tissue may not heal.

How do I take care of the skin around my Jackson Pratt drain entry site?

Change bandages at the JP drain entry site every day to keep it clean and dry. Your caregiver will tell you if you need to do this more often. Collect the following items and place them where they can be reached easily:



  • Two pairs of clean medical gloves.
  • A clean container.
  • 5 to 6 new cotton swabs.
  • New gauze pads.
  • Saline solution or soap and water.
  • Plastic trash bag.
  • Surgical tape.
  • Waterproof pad or bath towel

Follow these steps to care for your skin around the JP drain entry site:

  1. Wash your hands with soap and water. Dry your hands and put on clean gloves.
  2. Loosen the tape and gently remove the old bandage. Throw the old bandage into a plastic trash bag.
  3. Look for any new redness, swelling, or pus at the place where the drain enters your skin. Check for a foul (bad) smell coming from the area. Tell caregivers if you see any of these changes. Make sure the stitches that attach the JP drain to your skin are tight. Tell caregivers if they are loose or missing.
  4. Place a waterproof pad or towel under the JP drain to soak up any spills.
    Pour a small amount of saline solution or clean water into a container. Dip a cotton swab in the solution once. Gently clean the skin around the drain, moving in circles. Start from the place where the drain enters your skin and clean outward in circles, moving away from the insertion site. Clean your skin 3 to 4 times, using a new swab each time.
  5. Let the skin dry. Take your gloves off and put on a clean pair. When the area is dry, put a new bandage around the JP tube entry site. Use surgical tape to hold it down against your skin. Tape the tubing down to the bandages. Attach the bulb to your clothing using a safety pin.
  6. Throw all used supplies in the trash bag along with your gloves. Wash your hands after you are finished.

When do I empty the Jackson Pratt drain?

For the first 24 hours (one day) after most types of surgery, there will often be drainage coming out of the wound. Check the drain at least every four hours. Empty it if it is half full of fluid. Do not let the drain fill up any more than half full. After one day, empty your JP drain when it fills up half way, or every 8 to 12 hours even if it is not half full. After the drain is emptied, the empty bulb needs to be squeezed. This is done to keep the suction of the JP drain strong enough to pull out more fluid.

How do I empty the Jackson Pratt drain?

  • The following are general directions for emptying the JP drain bulb, and squeezing the bulb. Gather the following supplies, and place them where they can be easily reached:
  • One pair of clean medical gloves.
  • Clean measuring container.
  • Cotton balls.
  • Medical alcohol or alcohol swab.

Follow these steps to empty the JP drain:

  • Wash your hands with soap and water. Dry your hands and put on clean gloves.
  • Place a waterproof pad or towel under the JP drain to soak up any spills. Place the bulb lower than the wound to prevent fluid from going back into your body. Check the bulb for any holes or cracks.
  • Remove the plug at one side of the bulb and pour the fluid into a measuring container. Do not touch the tip of the spout with the mouth of the collection cup or anything else. This keeps germs from getting inside the bulb and tubing. Clean the plug with a cotton ball dipped in alcohol, or an alcohol swab.
  • Squeeze the bulb tightly while the plug is still off. Do not squeeze the bulb if the plug is in place. While the bulb is being squeezed, put the plug back to seal the bulb. If you cannot squeeze it and plug it at the same time, ask someone for help. You may also place the bulb on a hard surface, such as a table. Use your elbow or hand to press down hard on the bulb, and then stick the plug in it.
  • Measure the amount of fluid that came out of the JP drain bulb. Write down the amount, color, and odor of the fluid, and the date and time that you collected it. Use a piece of paper, a notebook, or JP drainage chart to keep track of this information.
  • Flush the fluid down the toilet. Throw all used supplies in the trash bag along with your gloves. Wash your hands after you are finished.

What can I do to prevent problems with my JP drain?

  • Always keep the bulb lower than the wound. This will stop the fluid from going back into your body.
  • Do not pull on the tubing. This can loosen the stitches holding the drain to your skin, causing the drain to fall out.

When should I call my caregiver? Call your caregiver if:

  • The fluid removed by the JP drain is cloudy, yellow, or foul-smelling.
  • You have more swelling or redness where the drain enters your skin.
  • You feel more pain in the area of your drain.
  • You see holes or cracks in the tubing or bulb of the drain, or the drain is leaking.
  • When should I seek immediate help? Go to the nearest emergency room if:
  • Liquid has suddenly stopped coming into the bulb of your JP drain.
  • The JP drain starts filling up very quickly with bright red blood.
  • The JP drain stitches come loose or break off.
  • You have a fever (increased body temperature).
  • Your bandages are soaked with blood.
  • Your JP drain comes out.

source: http://www.drugs.com/cg/jackson-pratt-drain-care.html

Flower Girl

I love weddings. I even watch it a lot on TV from famous stars to Bridezella . This will be my 4th wedding that I will going to attend here in the US. It's so much different in US culture compared to Filipino tradition. A Filipino groom is mostly responsible for all financial aspect . At least that's how I had observed . Here in America , the brides parent is responsible for paying the reception . The most expensive part in a wedding.


Josh and his fiancee Elene are getting married in May. Josh is Isabel's first cousin . He is the son Becky and Don Trull. Becky is my husband's older sister.


Isabella is going to be one of the flower girl along with Kirsten. She is Isabel's 3 yeard old 2nd cousin. Yehahhh... I already bought a dress from http://www.cutieclothes.com/



So, I guess we are going shoe shopping when her Daddy felt better. For now, I will just look in the web.

( pictures: from cutieclothes.com)

Adding another JP - hubby's update




We woke up today with high hopes that we are heading home. But I guess not. He is been restless for staying in the hospital since last Thursday . It is better to stay here and they can take care of everything but on the other hand it is impossible to rest. So, we are both sleep drive specially him .

Doctors came in early with good and bad news . Their suspicion was correct. Based on the CT scan result, the first abscess shrunk but the second is not draining. So, he will have to undergo another 1 hours procedure where they can add another JP to drain the infection and it will be CT guided so they will not accidentally poked on anything important. ( cross my finger ! ) The good news, White blood cell count fall below and it means we will be out in here in a few days. There is also an infection in the incision but that can be taken care by oral anti-biotics ( I hope! ) We have been told since Saturday that we can go home but some things pop up that prevent doctors from sending us home. It's good in a way. I rather for them to take care of the infection rather than me panicking at home .


So, that's were we stand at this point. This coming Monday April 20th, I'm supposed to go back to work. I'm hoping I can really take a good rest . My kind of work is so demanding and entails attention to details. One wrong step is like a panic button ringing in every department.

I am currently waiting right now while blogging in Surgery waiting room. Someone will inform me if they are done. He went past 11:00 am and it is now 12:51 . Hopefully, everything is all right.




Definition of JP drain ( source: http://www.medterms.com/ )



JP drain: The original suction drain. The drain itself is inside the body. It is made of Teflon and has multiple drainage holes. The drain is connected to clear plastic tubing which is usually sutured to the skin at the point it leaves the skin. The tubing connects to a bulb reservoir. The bulb, when squeezed empty, applies constant suction to the drain and pulls the fluid out of the body. The drain is removed when the excess fluid has stopped draining from the body. A JP drain may be used, for example, for abdominal or thoracic drainage. JP stands for Jackson-Pratt.