What physical finding around the chest tube site suggests subcutaneous emphysema?

• A. Redness around the chest tube site
• B. Crepitus/subcutaneous emphysema around the chest tube site
• C. Fever
• D. Absence of sensation

Answer: (B)

Subcutaneous emphysema occurs when air leaks into the tissues under the skin, often from a pneumothorax or along the chest-tube tract. The key physical finding around the chest tube site is crepitus—a crackling, rice-crispies feel you can sense when you palpate the skin. This sensation directly indicates air in the subcutaneous tissues, making it the best clue that subcutaneous emphysema is present. Redness around the site points to inflammation or infection, fever signals infection systemically, and absence of sensation suggests nerve issues, none of which describe air in the tissues. If crepitus is detected, assess the chest tube’s patency and position, check connections for leaks or disconnections, and obtain imaging to evaluate the pneumothorax and guide management.