This is a case of pneumothorax where we have an intercostal drainage tube. The tube is attached to an underwater seal. As you see, the tube goes underneath the water, so that air can escape but cannot enter into the pleural space. So this is the idea of putting an intercostal drainage tube attached to an underwater seal. Gradually, air from the pleural space will go out but cannot come back.
That way, the lung gradually expands. Now, we can enhance this. You give some chest physiotherapy especially expiratory exercise which raises the intrathoracic pressure so that air can escape. For example you can just ask him to cough. When the patient coughs the air from the pleural space escapes here.
So this is a good form of exercise. The best way is to give some balloons to the patient to blow. As a child he loves to do it. Or you can give him an incentive spirometer where he blows and increases the level of his intrathoracic pressure so that air gradually escapes. So this is the idea behind an intercostal drainage tube attached to an underwater seal. Most pneumothoraces, in particular closed pneumothoraces, will expand on this.
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