Which finding on a chest tube system indicates an air leak?

• A. No drainage
• B. Pain at the chest site
• C. Fever
• D. Continuous bubbling in the water-seal or suction chamber

Answer: (B)

Continuous bubbling in the water-seal chamber (and in the suction chamber when suction is applied) signals an air leak. Air from the pleural space is traveling through the chest-tube system rather than being contained by the water seal, so a steady stream of bubbles indicates a persistent leak along the tube, at the insertion site, or in the lung. Intermittent bubbling can occur with normal breathing or coughing, but a continuous pattern means the system isn’t fully sealing off air from the chest. If this is observed, inspect all connections for looseness or disconnection, ensure the tube isn’t kinked or dislodged, and notify the clinician if the leak persists, as it may require repositioning, additional suction adjustments, or imaging. Other findings like no drainage, fever, or chest-site pain do not specifically indicate an air leak in the chest-tube system.