What should you do if a chest tube becomes dislodged at the bedside?

• A. Apply a sterile occlusive dressing to the site immediately and notify the clinician; be prepared for reinsertion.
• B. Call for replacement surgery immediately.
• C. Remove the chest tube and cover the site with a dry gauze.
• D. Let the dressing air-dry and monitor.

Answer: (B)

When a chest tube becomes dislodged, the immediate priority is to seal the chest wall to prevent air from entering the pleural space and risking a new or worsening pneumothorax, while getting the tube reinserted by a trained clinician. Quickly apply a sterile occlusive dressing over the insertion site and secure it so air cannot flow into the chest, then notify the clinician and prepare for reinsertion at the bedside or in the operating suite per protocol. Do not remove the tube or rely on a dry gauze or loose dressing, and don’t delay reinsertion while waiting for further steps. After reinsertion, reassess breathing and imaging as ordered.