1. I had an exam today and could not remember which way the water level goes during tidaling during respiration. Does the water level go UP when the pt inhales or down when the pt inhales. ....anybody have a good way to remember that?
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    Joined: Mar '09; Posts: 144; Likes: 106
    Specialty: Paramedic 15 years, RN now


  3. by   JeanettePNP
    Tidaling indicates fluctuations in the water-seal chamber's fluid level that correspond with respiration. On inspiration, increased negative pressure in the pleural cavity increases the water level. On expiration, decreased pleural pressure decreases the water level. Shallow breathing causes less fluctuation and labored breathing causes more.

    Eliminate the air of mystery from chest tubes - page 4 | Nursing
  4. by   MEDICJOHN

    Thank you for your reply.
    However, the article you referred me to says that ANY bubbling in the water chamber, other than when first inserted, means there is a leak and the nurse should try to locate it.
    I have worked in the ER for 10 years and our chest tube set ups ALWAYS have a gentle bubbling in the bottom.
    Also, my text says some models DO have a gentle bubble but a VIGOROUS bubbling is not appropriate.
    Can you clarify please?

  5. by   JeanettePNP
    I would go with what your text says.
  6. by   swnewrngrad
    I think that in the ED what you are seeing is when it is hooked up to suction and the tidaling and bubbling that they are referring to is in chest tubes which are not hooked to suction. May be wrong here but what I found online seems to lead in that direction.