How would you manage suspected obstruction or kinking of a chest tube?

• A. Inspect tubing for kinks, straighten, reposition if needed, ensure the drainage system is not inverted, notify clinician if obstruction persists.
• B. Clamp the chest tube immediately.
• C. Increase suction to max regardless of patient status.
• D. Remove the chest tube.

Answer: (A)

Addressing chest-tube obstruction starts with ensuring the tube remains patent and the setup is correct. Inspect the external tubing for kinks or twists, straighten and reposition as needed, and make sure the drainage system is oriented properly and not inverted or flooded. If the tube still seems obstructed after relieving any mechanical issues, notify the clinician so further evaluation can be done (there may be a clot or another issue inside the tubing or the chest). If suction is used, verify it’s connected and set to the prescribed level and that all connections are secure.

This approach is best because it directly targets the common mechanical cause of obstruction and corrects the setup to allow drainage to occur, while also involving clinical input for more complex problems. Clamping the chest tube can trap air and lead to tension pneumothorax; increasing suction to maximum without assessment can cause injury and doesn’t fix the obstruction; removing the chest tube would abandon necessary drainage and could worsen the patient’s condition.