What is the initial approach when a chest-tube tract shows signs of infection or malposition?

• A. Escalate to clinician for assessment and possible imaging or tube adjustment
• B. Ignore and continue
• C. Replace the chest tube without assessment
• D. Apply lotion to skin

Answer: (A)

When a chest-tube tract shows infection or signs of malposition, the first and most important step is to involve a clinician for assessment and possible imaging or tube adjustment. Infection around the tract can progress quickly and may require antibiotics or drainage changes, while malposition can prevent proper drainage and risk injury to the lung or surrounding structures. A clinician will typically order imaging, such as a chest X-ray, to verify the tube’s position and the status of the pleural space, and decide whether repositioning or other intervention is needed. In the meantime, check that the drainage system is patent and below chest level, and ensure the tube is secure and free of kinks. Avoid blind adjustments or replacing the tube without guidance, and do not apply unrelated topical lotions to the skin.