Air Leak

Intermittent bubbling during expiration is normal. Continuous bubbling in water-seal chamber suggests an air leak.

• Clamp chest tube (order needed) using toothless clamps close to chest wall.
• If bubbling stops: Air leak is within Pt or at insertion site. Unclamp chest tube, reinforce insertion site with occlusive dressing, and notify HCP.
• If bubbling continues: Clamp chest tube (using second toothless clamp) at drainage unit.
• If bubbling stops, air leak is in tubing. Replace tubing.
• If bubbling continues, air leak is in drainage system. Replace system.

Disconnection in System

• While preparing to reattach tube/connections: (1) submerge distal end of tube under 1 to 2 in. of sterile water or normal saline, or (2) attach a one-way (Heimlich) valve.
• Clean exposed ends with Betadine swabs for 30 sec (air-dry for 30 sec). Reconnect and retape drainage system.
• Replace all contaminated connections, including new drainage system, as quickly as possible to prevent a pneumothorax.

Chest Tube Dislodgement

See Respiratory Problems and Disorders