一位放置胸管的病人突然出現呼吸困難，護理師觀察到水封瓶（water seal chamber）持續冒氣泡。護理師應先做什麼？
A client with a chest tube experiences sudden respiratory distress. The nurse notes the water seal chamber is bubbling continuously. What should the nurse do first?
- ACheck the connections between the tube and the drainage system✓ 正解檢查管子與引流系統之間的連接
- BIncrease the suction level on the drainage system增加引流系統的抽吸水平
- CClamp the chest tube close to the insertion site to locate the leak在插入部位附近夾閉胸管以定位洩漏
- DPlace the end of the tube in sterile water將管子末端放入無菌水中
胸管引流系統出現持續性冒氣泡（Continuous bubbling），通常代表系統內存在氣體洩漏（Air leak）。護理師應先檢查系統的所有連接處（Connection）是否鬆脫，因為這是最常見且容易排除的原因。若連接處緊密，則需考慮傷口處是否漏氣。增加抽吸壓力不會解決洩漏問題，反而會加劇氣體流動。只有在確認洩漏點時，才能在醫師指示下夾住胸管，但絕對不能在未經評估下長時間夾閉。
Continuous bubbling in a chest tube drainage system typically indicates an air leak somewhere in the system. The nurse should first check all connections in the system for looseness, as this is the most common and easily corrected cause. If the connections are secure, then leakage at the insertion site should be considered. Increasing suction pressure will not resolve a leak and may worsen the air flow. Clamping the chest tube to locate the leak may be done only briefly under physician direction, and the tube must never be clamped for an extended time without assessment.
美國教學強調「胸管不能隨意夾閉」，除非是為了尋找洩漏點或準備拔管。台灣臨床偶見護理師為了病人移動或檢查而習慣先夾管，在 NCLEX 中這是不正確的做法。