How should a chest tube be secured to prevent dislodgement?

• A. Leave it loosely attached
• B. Apply a sterile, occlusive dressing and secure with tape or sutures as per protocol to minimize movement
• C. Use non-sterile tape
• D. Only tape the top, not occlusive

Answer: (B)

Securing a chest tube hinges on preventing movement at the insertion site while keeping the wound sterile and sealed. The best approach is to place a sterile, occlusive dressing over the insertion site and secure the tube with tape or sutures according to protocol. This creates a continuous, airtight seal so air cannot enter or escape around the tubing, and it anchors the tube to the skin to resist pulling or tugging. Following protocol for securement also ensures the fixation is durable and appropriate for the patient, reducing the risk of accidental dislodgement and infection.

Leaving it loosely attached increases the chance of the tube being pulled out or shifting, which can lead to loss of drainage, re-accumulation of air in the chest, or injury. Using non-sterile tape risks infection and inadequate adhesion. Only taping the top and not creating a sealed, occlusive dressing fails to prevent air leaks and does not adequately secure the entire tract or the tube's depth, increasing dislodgement risk.