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Q) 1 hr after undergoing splenectomy for injuries sustained in a motor vehicle accident, a 42 yr old man has severe shortness of breath. additional injuries include left rib and pelvic fractures.his temp. is 36.3C(97.4F),pulse 133/min, resp rate 35/min, bp-80/60 mm Hg.breath sounds are absent on the left side. abdomen shows slight distension bowel sounds r absent. whuch f the following is the most appropriate next step in management.
a)x ray of chest
b) transfusion of type specific uncrossmatched blood
c)intravenous heparin therapy
d)fibreoptic bronchoscopy
e)endotracheal intubation
f)placement of venacava filter
g)needle thoracostomy
cud ull plz explain.
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this pt has hemothorax .. surgery is the answer .. open and see .. there's no time for other mwasures i think .. G
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@ash_cardio: we cant use a needle thoracostomy to drain a hemothorax. it can only be used for pneumothorax .
well thats wat i think. correct me if i am wrong.
i answered a) and got it wrong
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this is pneumothorax, treat it first (ABC), the heart compression will be relieved--U'll see improved BP. so, GG the answer.
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breath sounds are absent on the left side...GG
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i have a doubt regarding the development of tension pneumothorax. can it develop so much later after an injury ??? . coz the patient has undergone a splenectomy and 1hr later he develops breathlessness. ?
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guys if you have a recent rib frascture you can have a pneumothorax anytime so i would go for ggggg
