If a patient pulls out a chest tube, what is the immediate action?

If a patient pulls out a chest tube, what is the immediate action?

• A. Place a saline dressing over the exit site
• B. Place an occlusive dressing over the puncture site
• C. Position the client on his right side
• D. Call for the on-site physician

Answer: (B)

When a chest tube is pulled out, the immediate danger is air entering the pleural space, which can cause or worsen a pneumothorax. The first action is to seal the exit site so air cannot be drawn into the chest. An occlusive dressing creates that barrier and, when secured properly (often with tape on three sides to allow air to escape but prevent inward air), helps prevent further air entry while you arrange for further care. After applying the dressing, promptly inform the on-site physician and be prepared for any orders to re-establish chest tube management. Other options don’t address the urgent need to seal the chest tube site: a saline dressing doesn’t seal, repositioning the patient doesn’t stop air entry, and calling the physician, while essential, isn’t the immediate manual action to prevent a pneumothorax.

When a chest tube is pulled out, the immediate danger is air entering the pleural space, which can cause or worsen a pneumothorax. The first action is to seal the exit site so air cannot be drawn into the chest. An occlusive dressing creates that barrier and, when secured properly (often with tape on three sides to allow air to escape but prevent inward air), helps prevent further air entry while you arrange for further care. After applying the dressing, promptly inform the on-site physician and be prepared for any orders to re-establish chest tube management. Other options don’t address the urgent need to seal the chest tube site: a saline dressing doesn’t seal, repositioning the patient doesn’t stop air entry, and calling the physician, while essential, isn’t the immediate manual action to prevent a pneumothorax.