1. Explain procedure and reassure patient and put him/her in the fowlers or semi fowlers position.
  2. Check vital signs and record (baseline data).
  3. Wash hands and don gloves.
  4. Place bottle below the chest level in a receptacle.
  5. Check the rate and depth of respiration, chest movements and auscultate his lungs periodically.
  6. Observe dressing site for bleeding and dislodgement of tube and inspect air vent in the system periodically.
  7. Check fluid level fluctuation and bubbling in the drainage system.
  8. Check tube for kinking or perforations.
  9. Encourage patient to cough frequently and breathe deeply every two hours if indicated.
  10. Assess patency of drainage system as evidenced by oscillations in the tubing and bubbling in the water.
  11. Tell patient to report any breathing difficulty immediately.
  12. Check and change the chest tube dressing when necessary and palpate the area surrounding the dressing for crepitus.
  13. Observe the volume, colour, consistency and odour of the drainage.
  14. Thank patient for co-operation, wash and dry hands.
  15. Administer pain medication as medication as needed for patient’s comfort.
  16. Encourage chest expansion exercise (blowing of balloon).
  17. Wash and dry hands again and document procedure noting no. 13.