Classic presentation: tall slim individual (like me : ))
with a sudden onset of tachypnea and tachycardia and chest pain, smoking
history is irrelevant ….
The good thing diagnosis with x- ray should be done (trust
me I’ve worked in places even to do x-ray is difficult!) so need to know
diminished air entry with decreased TVF should make you suspect a pleural effusion or a
pneumothorax.
How to manage? In other words, when to observe and monitor
and follow up with serial x-rays
And when to administer an under- water seal
Pneumothorax occupying less than 15% of the hemithorax
doesn’t need a cardiothoracic consultation, just admit the patient and monitor him closely, another information I
find it useful to mention is that the size of pneumothorax should decrease
gradually by 1.5% every 24 hours of its size if you did a follow-up x- ray and couldn’t find
that , I suggest to consult the cardiothoracic department : ))
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