D/c cranial drains

Materials: 
• sterile gloves
• 2 small chloroprep prep sticks
• Nylon 3-0s (have 2 ready, open 1)
• Straight kelly
• Suture removal kit

Do a mini time-out with yourself. Confirm the patient, room #, and location of drain you're removing!  
While Unsterile
1. Take drain off suction
2. Lie patient flat if drain is subdural 
3. Unwind buddy stitch from around tubing and cut off the knot (i.e. make it ready to tie) 
4. Prep around drain hole in skin and 6-12 inches up the tubing
Sterile
1. Pull drain with hand #1 while lifting up buddy stitch vertically with hand #2 
2. Plug hole with your finger if there is any delay in tying down buddy stitch (do not let air enter) 
3. Tie very tightly ≥ 4-5 knots (this is most painful part for patient but you need to be tight, especially sinch the second knot)
4. If tie rips or you airknot, you must throw in another figure of 8 stitch
5. Dry the area and try to express a leak 
+/- post-pull CTH as warranted (per chief) - TELL NURSE AND PLACE ORDER