A client with a chest tube is being transferred between units. During transport, the chest tube drainage system accidentally tips over. What is the priority action?

Chest tube management during transport:

Drainage system positioning: Must remain upright to maintain the water seal; the water seal prevents air from entering the pleural space.

System tipped: Priority is to return to upright position quickly; if water seal is disrupted (water spilled), notify RN immediately — the seal must be maintained.

Clamping controversy: Chest tubes should NOT be routinely clamped during transport (risk: tension pneumothorax if air is entering and tube is clamped).

Exceptions: Clamp briefly only if the system must be changed, or per specific physician order.

During transport: Keep system below chest level; prevent pulling on the tubing; have clamps available (not applied) in case system disconnects; if tube disconnects, submerge the end in sterile water to restore water seal until replacement system can be set up.

Pn scope: Monitor the drainage system; report changes; do not independently clamp without RN/provider direction.