Bedside procedures

How to care for a chest tube

Other platforms explain it with text and video. In VMS you practice it on the patient.

Nursing (NCLEX)
Practice it in VR with Blocky

Chest tube care is mostly watching: the system, the drainage and the patient.

Step by step

  1. Patient first

    Breathing, saturation, pain, dressing dry and intact. [1]

  2. System below the chest

    Drainage unit upright, below chest level, tubing without dependent loops or kinks. [1]

  3. Water seal

    Fluid rising and falling with breathing (tidaling) is normal; continuous bubbling suggests an air leak. [1]

  4. Drainage

    Mark level and time; report sudden increase or bright red blood per order. [1]

  5. Do not clamp

    Unless ordered; keep sterile water and an occlusive dressing at the bedside. [1]

  6. Emergencies

    Disconnected: put the tube end in sterile water. Pulled out: cover with an occlusive dressing taped on three sides and call. [1]

Common errors

Practice it in VMS

In VMS you do this on the patient, not on paper: every step goes on the checklist with a score, and in Teach mode Blocky tells you what comes next.

VMS cases that train this skill

Sources

  1. Open RN, Nursing Skills 2e (Chippewa Valley Technical College) (CC BY 4.0)
  2. OpenStax, Clinical Nursing Skills (CC BY 4.0)

Steps adapted from Open RN, Nursing Skills 2e (Chippewa Valley Technical College) and OpenStax, Clinical Nursing Skills, licensed under CC BY 4.0. VMS is not affiliated with these organizations. Updated: 2026-10-11.