In this instructional video, the presenter outlines four essential concepts that nursing students must master for chest tube care and exam preparation. First, she explains the difference between intermittent bubbling (normal) and continuous bubbling (sign of an air leak) in the water‑seal chamber, emphasizing that the latter requires immediate attention. Second, she stresses the importance of keeping the chest tube tubing lower than the patient’s chest to ensure proper drainage, likening it to catheter positioning and sharing a personal anecdote about her own nervous first clinical day. Third, she lists critical signs that warrant calling the physician, including sudden increase in drainage volume (especially >70–100 mL/hr), bright‑red or new drainage on the dressing, continuous bubbling, changes in respiratory pattern, altered mental status, or signs of shock, and advises students to use critical‑thinking and facility policies when deciding whether to act or to notify the doctor. Fourth, she describes the emergency management of a dislodged chest tube: apply an occlusive dressing taped on three sides, leaving one side open to allow air escape and prevent tension pneumothorax, then call for help. Throughout, she encourages viewer engagement, promotes channel subscription, and promises additional critical‑care content.
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In this video, I'm going to give you four vital things you need to know about chest tubes in nursing school. You've got to know these things because they will probably show up on your exam somewhere, and you definitely need to know them for clinicals. Before we get started, make sure you're subscribed to this channel so you do not miss out on any other nursing school tips and resources that I've got for you. Now, let's dive in. So the first thing you must know about chest 2 in nursing school is that there is a difference between continuous bubbling and intermittent bubbling in the water seal chamber. So chest tubes can be used to help get air out from around the lungs. And that water seal chamber is where all the air goes when it leaves the body. Normally, what happens is as air leaves the pleural space around the lungs, it travels down into the chest tube and into that water seal chamber and it causes a little bit of bubbling in that water seal. This is intermittent bubbling, and that is totally fine. Just means that the chest tube is doing its job and it's getting air out of the pleural space from around the lungs. However, if there is continuous bubbling in that water seal chamber, that indicates that there's an air leak somewhere, because the water seal chamber will be bubbling continuously, like, all the time, meaning that that air is constantly passing through, which is not normal for when air is just trying to get out of the lungs. So remember, intermittent bubbling is normal, but continuous bubbling indicates an air leak. Now, the second thing you must know when taking care of chest tubes in nursing school is you must keep the chest tube lower than the chest. Now, this allows it to drain properly and maintain the proper pressures. I always like to equate it to catheters. It's kind of the same thing. Always keep them lower than the level of the patient because then this will allow it to drain properly. I remember my first day at clinical on an critical care floor, and I was so, so nervous to help the patient with their chest tube. And you know how when you're nervous, you just forget about everything? Does that happen to you, too? That's what happened to me. And sometimes in nursing school, my mind would just go totally blank. So, thankfully, I had a really great nurse that helped walk me through how to do all of it, and she reminded me to keep that chest tube lower than the patient's chest. I was so careful with it, tiptoeing around as I moved it to where she wanted it. That was really, really scary. I totally remember that. It's always really scary when you do new things and try new things in nursing school. And even something that can seem super minor is moving a chest tube. It can be super terrifying in nursing school. I cannot be the only one that feels this way. So if you're with me and you totally get this, let me know down in the comments. I'm telling you I cannot be the only one who feels this way. Now, the third thing you absolutely have to know about learning chest tubes in nursing school is when to call the doctor. Now of course this is not an exhaustive list, so always use your amazing critical thinking skills and always check the policies at your facility. But here are some times when you would want to contact the doctor. You'll want to call the doctor if the drainage suddenly increases changes in color to bright red, if there's new drainage on the dressing, or if the output is greater than 70 to 100100 milliliters per hour, if there's an air leak in the system. So like we talked about before, if you see that continuous bubbling in the water seal chamber, or if a patient, if the patient has breathing pattern changes or a change in mental status, or if the patient is having signs or symptoms of shock. So those are all times when you would need to contact the doctor. Keep all of those things in mind as you take your nursing school exams because sometimes they will give you a question about what your priority nursing action or first initial action would be. And then there are times that you just there's not much you can do like if their chest tube output is greater than 100 milliliters per hour. So read your nursing exam questions carefully and decide when you can do something as the nurse and when you would need to contact the doctor. Now the fourth thing that you need to know about when learning chest tubes in nursing school is what to do in an emergency. Like if the chest tube comes out before it's supposed to. Ah, and this is one of thing that nursing schools just love to test you on. So you've got to pay attention here. If the chest tube comes out, you will need to take an occlusive dressing and put tape around three sides of the dressing, leaving the fourth side open. Remember that leave the fourth side open and put it over the wound. Then call for help. You must must make sure the air can get out of that pleural space. That's why you need to leave one of the sides open on that occlusive dressing. If you close all of the sides, that could cause a tension pneumothorax where air gets trapped inside that pleural space around the lungs and it puts pressure on blood vessels and all the organs in the chest. So by taping only those three sides of the dressing it allows some of that air to escape and not get trapped. So friend, the next time you take your nursing school exam please remember these four key points about chest tubes. Trust me, they will show up on your exams eventually because nursing instructors just love to test you on this stuff. So if this video helped you out, write love in the comments below and make sure of course as always that you're subscribed to this channel and click the notification bell so you never miss a video. And I've got another awesome critical care video for you coming up next so stick around and check it out to help you keep rocking critical care in nursing school and go become the nurse that God created only you to be and I will see you over there.
