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학습 자료 둘러보기 →In a patient with rib fractures and a chest tube, the highest priority is assessing for tension pneumothorax. A functioning chest tube does not rule out a new or worsening air leak that can overwhelm the system, leading to mediastinal shift and cardiovascular collapse.
Key assessment findings include severe respiratory distress, tracheal deviation away from the affected side, distended neck veins, absent breath sounds, and hypotension. This is a clinical diagnosis that requires immediate notification of the physician and preparation for emergency decompression.
Never clamp a chest tube to assess for an air leak without a specific order, as this can rapidly convert a simple pneumothorax into a tension pneumothorax. Continuous bubbling in the water seal chamber indicates a persistent air leak requiring immediate evaluation.
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