شاب عمره ٢٩ سنة عنده أنبوب صدر بعد إصابة في الصدر. أثناء تحريكه للأشعة خرج الأنبوب بالكامل من صدره، والجرح مفتوح وينفث هواء. المريض قلق، والتشبع ٩٤٪، والتنفس ٢٤. ما أول إجراء؟

A 29-year-old with a chest tube after chest trauma has the tube pull out completely while being moved for an X-ray; the wound is open and air is escaping. He is anxious; SpO2 94%, RR 24. What is the first action?

1. Reinsert the tube through the same opening
2. Cover the site immediately with a sterile dressing taped on three sides
3. Leave the site uncovered until the doctor arrives
4. Seal it with an occlusive dressing on all four sides and leave it

Answer: B) Cover the site immediately with a sterile dressing taped on three sides. A three-sided dressing stops air entering on inspiration but lets it escape on expiration, reducing tension pneumothorax risk. The physician is then notified and breathing monitored. Nurses do not reinsert the tube.