一位接有胸管的病人，其水封瓶（water-seal chamber）出現持續性氣泡。護理師應先採取什麼動作？
A client with a chest tube has continuous bubbling in the water-seal chamber. What is the nurse's first action?
- AIncrease the suction pressure增加抽吸壓力
- BNotify the physician immediately立即通知醫師
- CCheck the entire tubing system for air leaks✓ 正解檢查整個管路系統是否有漏氣
- DClamp the chest tube close to the insertion site在靠近插入處夾住胸管
胸管水封瓶出現持續性氣泡（continuous bubbling）通常代表系統存在空氣洩漏（air leak）。在排除胸膜腔內仍有殘餘氣體的情況下，護理師應採取系統性評估，從管路連接處開始，由病人端往引流瓶端逐步檢查，以定位漏氣點。嚴禁在未經醫囑或明確指引下隨意夾閉胸管，因為這可能導致空氣滯留在胸膜腔內，引發致命的張力性氣胸（tension pneumothorax）。
Continuous bubbling in the water seal chamber of a chest tube typically indicates an air leak in the system. After ruling out residual air in the pleural cavity, the nurse should conduct a systematic assessment, starting at the tube connections and moving from the patient end toward the drainage chamber to locate the leak. Clamping the chest tube without a physician's order or clear instructions is strictly prohibited because it may cause air to be trapped in the pleural cavity, leading to fatal tension pneumothorax.
美國臨床對於胸管護理極度強調「不主動夾管」的原則。若需檢查漏氣，通常會短暫且小範圍地測試，但台灣部分臨床習慣可能較為隨意，赴美執業務必遵守嚴格的管路安全規範。