What does continuous bubbling in the water seal chamber indicate?

• A. Air leak — notify provider
• B. Fluid leak — replace chamber
• C. Kinked tube — adjust
• D. No issue — continue monitoring

Answer: (A)

Continuous bubbling in the water-seal chamber signals an ongoing air leak in the chest drainage system. The water-seal chamber is expected to be quiet; bubbling means air is moving through the seal, coming from the pleural space or from a leak in the tubing or connections. This is not normal and can indicate a pneumothorax or a loose/disconnected tube, so the clinician should be notified right away to assess and manage the leak. While awaiting evaluation, check for external disconnections or loose connections, ensure the chest tube is patent, and verify that the system isn’t kinked or damaged. The other options don’t fit because a fluid leak would show fluid drainage issues rather than continuous air bubbling, a kinked tube would more likely reduce drainage or cause obstruction rather than create ongoing air leak, and continuing to monitor without addressing a persistent air leak would miss a potentially serious problem.