一位胸管連接閉鎖式引流系統的病人，下列哪些發現護理師應立即通知醫師？（選所有適合的）
A nurse is caring for a client who has a chest tube connected to a closed-chest drainage system. Which findings should the nurse report to the healthcare provider immediately? (Select all that apply.)
- AContinuous bubbling in the water seal chamber✓ 正解水封瓶內持續冒泡
- BFluctuation of the fluid level in the water seal chamber水封瓶內液面波動
- C200 mL of bright red blood drainage in the first hour✓ 正解第一小時內有200 mL鮮紅色引流液
- DSubcutaneous emphysema around the insertion site✓ 正解插管周圍出現皮下氣腫
- EThe chest tube becomes disconnected from the drainage system✓ 正解胸管與引流系統脫離
胸管引流的監測需特別注意系統氣密性與引流性質。持續性氣泡代表系統漏氣或肺部漏氣嚴重；短時間內大量鮮紅出血暗示活動性出血；皮下氣腫顯示空氣漏入軟組織；斷裂則導致氣胸風險。水封瓶液面隨呼吸波動是正常現象。
Monitoring of chest tube drainage requires particular attention to the airtightness of the system and the characteristics of the drainage. Continuous bubbling indicates a system leak or a significant pulmonary air leak; large amounts of bright red bleeding within a short time suggest active hemorrhage; subcutaneous emphysema indicates air leakage into the soft tissue; and disconnection creates a risk of pneumothorax. Fluctuation of the fluid level in the water seal chamber with respiration is a normal finding.
美國護理師對胸管脫落的緊急處理（如置入無菌水中）教育訓練非常嚴格；台灣臨床則更依賴醫師處理管路移除。