一位 40 歲男性右側創傷性氣胸病人的胸管連接到三腔式密閉胸腔引流系統。護理師觀察到深咳時水封室出現間歇性冒泡；30 分鐘後同一水封室卻出現持續劇烈冒泡。下列哪些結論正確？（多選題）
A 40-year-old male with a right-sided traumatic pneumothorax has a chest tube connected to a three-chamber closed chest drainage system. The nurse observes intermittent bubbling in the water-seal chamber during deep coughing, but 30 minutes later notices continuous vigorous bubbling in the same chamber. Which conclusions are correct? (Select all that apply.)
- ABrief intermittent bubbling during deep exhalation or coughing is a normal expected sign of trapped air escaping the pleural space.✓ 正解深吐氣或咳嗽期間短暫的間歇性冒泡是胸腔內積氣排出的正常預期徵象。
- BContinuous bubbling in the water-seal chamber is the gold standard of healing and should not be interrupted.水封室的持續冒泡是癒合的金標準，不應中斷。
- CContinuous bubbling in the water-seal chamber indicates an air leak somewhere in the system that must be located.✓ 正解水封室的持續冒泡表示系統某處有漏氣，必須加以定位。
- DAn air leak requires the nurse to immediately remove the entire chest tube from the client's chest.發現漏氣時，護理師應立即將整根胸管從病人胸部拔出。
- EThe nurse should briefly clamp the tubing sequentially from the chest outward to identify the source of the air leak.✓ 正解護理師應從靠近胸部處向外依序短暫夾住管路，以找出漏氣來源。
三腔式胸腔引流系統的水封室（water-seal chamber）作為單向閥：氣體可從胸腔流出，但不能回流。 選項 A 正確：深咳/吐氣時胸腔壓力升高，把氣推出 → 出現「間歇性冒泡」是預期正常現象。 選項 C 正確：持續冒泡表示有「氣體漏入」，可能在胸管接合處、引流管裂縫或胸管脫位。 選項 E 正確：依序由近端往遠端短暫夾住管路，當夾住某段後冒泡停止，即可定位漏氣處。 選項 B 錯誤：持續冒泡是異常徵象，不是癒合指標。 選項 D 錯誤：絕對禁止拔除胸管，會立刻造成張力性氣胸。
The water-seal chamber acts as a one-way valve in a three-chamber chest drainage system: air can leave the pleural space but cannot return. A correct: Intermittent bubbling on deep exhalation or coughing is the expected sign of trapped air escaping. C correct: Continuous bubbling indicates an air leak—possibly at tubing connections, a crack in tubing, or chest tube dislodgement. E correct: Sequentially clamping from chest outward locates the leak (bubbling stops when clamp is past the leak). B incorrect: Continuous bubbling is abnormal, not a healing sign. D incorrect: Removing the chest tube would cause tension pneumothorax—absolutely contraindicated.
世界急重症公用常識：胸腔引流瓶 Water SEAL! 「Intermittent (間歇偶爾冒泡) = Good/Normal！代表正在排氣」 ; 「Continuous (不斷連續冒泡) = BAD/Air leak ！代表系統管子破洞漏氣了！」。這個公式是全世界醫院面試必考題。