In the event of a chest tube dislodgement, which action should be taken promptly?

• A. Place a saline dressing over the exit site
• B. Place an occlusive dressing over the puncture site
• C. Call for the on-site physician
• D. Position the client on his left side

Answer: (B)

When a chest tube is dislodged, the immediate priority is to seal the pleural space to prevent air from entering and potentially causing a pneumothorax. Place an occlusive dressing over the exit site right away and secure it around the tube, ideally taping down on three sides to create a flutter-valve effect that stops air from entering while allowing any air already in the pleural space to escape. After that, notify the physician and be prepared to assist with reinsertion or repositioning of the chest tube as ordered. A saline dressing would not provide a seal to stop air entry, and repositioning the patient or delaying action does not address the wound or lung risk.