What should a nurse check if continuous bubbling is observed in a chest tube drainage system?

• A. Check for an adherent chest tube to skin
• B. Inspect the collection chamber for color
• C. Check the suction pressure setting
• D. Check for an air leak in the system and tubing connections

Answer: (D)

Continuous bubbling means air is moving through the drainage system, which almost always points to an air leak somewhere in the chest-tube setup. The best answer is to check for an air leak in the system and tubing connections. Start at every connection from the chest tube to the collection chamber and to the suction source, making sure all joints are tight and intact, and that the tube isn’t disconnected, kinked, or pulled out. Also inspect the insertion-site dressing for any gap where air could be leaking around the chest tube. If everything is secure but bubbling continues, this may reflect an ongoing air leak from the lung, which needs clinician assessment. Avoid clamping the tube routinely because that can cause dangerous effects such as tension pneumothorax.