What signs would alert you to a chest-tube dislodgement?

• A. The tube is pulled out of the chest or dressing; sudden cessation or abrupt change in drainage; crepitus or subcutaneous emphysema around the insertion site.
• B. Increased lunch intake.
• C. Increased appetite.
• D. The tube becomes warm to touch.

Answer: (A)

Signs of chest-tube dislodgement revolve around losing the tube’s secure position and the resulting disruption of air and fluid drainage. If the tube is pulled out of the chest or the dressing comes loose, the tube is no longer in the pleural space, risking lung collapse and a new air leak. A sudden cessation or abrupt change in drainage points to a disruption in the drainage system or a shift in the intrapleural environment, indicating the tube may no longer be functioning where it should. Crepitus or subcutaneous emphysema around the insertion site is a clear sign that air is escaping into the tissues, confirming dislodgement. If you observe any of these, act quickly: cover the site with a sterile dressing taped on three sides to seal while allowing air to escape if needed, notify the clinician, and follow your protocol for reinsertion or securing the tube.

The other options don’t fit because appetite changes or increased food intake are unrelated to chest-tube position, and warmth at the tube site can suggest infection rather than an acute dislodgement.