Bottom line
Conservative management of stable unilateral, spontaneous primary pneumothorax, is not inferior to Seldinger drain, with lower risk of serious adverse events.
Majority of patient with unilateral primary spontaneous pneumothorax is safe for conservative management and discharge at 4 hrs, after a repeat CXR
High fragility index due to lost to follow-up means data is not statistically robust
Pain in the neck! Continue reading
An elderly woman on beta-blockers presented to the ED with hypotension and bradycardia, PR = 30/min. Her venous blood gases showed the following:
PH = 7.27
pCO2 = 38 mmHg
A 81 year old male presents to a regional emergency department, 4 hours away from a cath lab, complaining of chest pain. Below is the patients ECG:
80 year old male known diabetic, re-presents to ED after a recent admission in which the patient was diagnosed with TB. According to the wife the patient has been home for 2 days. Over the last 24 hours his oral intake has declined and he has become less responsive.
80 year old male known diabetic, re-presents to ED after a recent admission in which the patient was diagnosed with TB. According to the wife the patient has been home for 2 days. Over the last 24 hours his oral intake has declined and he has become less responsive.
PH = 7.255, that is moderate acidaemia
HCO3 = 19 mmol/L. That is low. Accordingly, we have metabolic acidosis.
Next step is to calculate the compensation and anion gap.
A 81 year old male presents to a regional emergency department, 4 hours away from a cath lab, complaining of chest pain. Below is the patients ECG:
The following right wrist x-rays are from a skeletally immature patient with wrist pain & swelling after a fall on outstretched hand. What can be seen? Continue reading