رجل عمره ٣٥ سنة عنده أنبوب صدري في اليمين بعد استرواح صدري. أثناء تحريكه في السرير للعناية بالجلد، انسحب الأنبوب بالكامل من جدار الصدر، والمريض صار قلقاً. التشبع ٩٤٪، والتنفس ٢٢. ما الإجراء الفوري؟

A 35-year-old man has a right chest tube for pneumothorax. While being repositioned for skin care, the tube pulls completely out of the chest wall and he becomes anxious. SpO2 94%, RR 22. What is the immediate action?

1. Cover the site with an occlusive dressing taped securely on all four sides
2. Leave the site open and monitor the client until the provider arrives
3. Cover the site with a sterile occlusive dressing taped on three sides
4. Quickly reinsert the tube through the same opening before it closes

Answer: C) Cover the site with a sterile occlusive dressing taped on three sides. A dressing taped on three sides acts as a flutter valve: it stops air entering on inspiration and lets it escape on expiration. Taping all four sides can trap air and cause a tension pneumothorax, reinsertion is a provider task under sterile conditions, and an open site lets air into the pleural space.