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Interactive Case Discussion #12. Kerby Chloe A. Go. CASE 12. 50/M Came in from another institution with severe difficulty of breathing. He came in with a chest x-ray done outside and when your resident saw the film, the patient was immediately referred for surgical management. - PowerPoint PPT Presentation
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Interactive Case Discussion #12
Kerby Chloe A. Go
CASE 12
• 50/M• Came in from another institution with severe
difficulty of breathing. He came in with a chest x-ray done outside and when your resident saw the film, the patient was immediately referred for surgical management.
• Repeat chest x-ray was performed afterwards exhibiting the following..
Chest tube Insertion
• inserted to drain blood, fluid, or air and to allow the lungs to fully expand
• Indication:– Pneumothorax– Tension pneumothorax– Hemothorax– empyema
Procedure
• Point of insertion: anterior axillary line• Aseptic technique and local anesthesia is
applied• The free end of the tube is usually attached to
an underwater seal below the level of the chest
Pneumothorax
• Collection of air or gas in the pleural cavity of the chest
• May occur spontaneously or with physical trauma, blunt injury/trauma, or as complication of medical therapy
• Presents as dyspnea in most cases
Tension pneumothorax
• If the penumothorax leads to oxygen shortage and low blood pressure, progressing to cardiac arrest
Pneumohydrothorax
• Air or gas with fluid in the pleural cavity
• Caused by:– Infectious
• TB– Neoplastic
• Mesothelioma– Anatomic, foreign body
or structural disorders• Perforated/ruptured
esophagus
• Common clinical surgical rule: pneumothorax greater than 25% requires chest tube drainage
• Air slowly resorbs from the pleural space at a rate of approximately 1.5% / day. This rate will increase with use of supplemental oxygen.
• www.chestx-ray.com/calculator/ptx.html - link for pneumothorax calculator