Forty-eight hours after the chest tube insertion Ms. Paul remains on mechanical ventilation. While assessing the chest tube system, you note small bubbles in the water seal chamber generated during peak inspiration. This is an indication of which of the following:

Question

Quizplus · Accepted Answer

Bubbling in the water seal chamber is an indication of a leak in the chest tube collection system. The leak can be generated by (1) cracked or broken collection system, (2) improperly positioned chest tubes, and (3) a persistent bronchopulmonary fistula. To rule out (1) versus (2), and (3), the chest tube should be clamped by the chest level. If the leak continues, the collection system is cracked or defective. If the leak stops, the chest tube is malposition or there is a bronchopulmonary fistula generating the leak.

Forty-Eight Hours After the Chest Tube Insertion Ms