12-01-2006, 02:17 PM
I though that O2 therapy at home start at pao2 of 55?!
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KQbank--trauma - hunanliu
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12-01-2006, 02:28 PM
Pa O2 and pulse oximetry are different, home o2 starts at either a Pao2 of 55 mm or a pulse oximetry of 89%. one is partial pressure of oxygen and one is percent saturation of blood with oxygen.
12-01-2006, 08:46 PM
The correct answer is E. This patient has developed a right-sided pneumothorax.
Based on her oxygen saturation and complaint of shortness of breath, she is becoming symptomatic from this pneumothorax. Treatment, which must not be delayed, requires draining her right pleural space, which is filled with air and possibly blood from her trauma. There is no indication to intubate this patient (choice A). She is awake and oriented. Her airway is not in danger. Intubation helps to protect the airway and oxygenate the patient. She can protect her own airway and oxygenation will not be improved until the pneumothorax is treated. Arterial blood gas will not provide you with any information that you don't already know (choice B). It will only delay the appropriate treatment. A CT scan is time consuming and expensive (choice C). A pneumothorax is diagnosed by history and physical examination. There is no reason to wait for a chest x-ray in this patient (choice D). The patient's clinical condition may worsen while awaiting the results of the x-ray.
12-03-2006, 09:35 AM
i still do not see the point of inserting a chest tube . hmmmm ok base line Q - what are indications of CXR in a pt suspected of having hemo or pneumothrax ?
12-03-2006, 11:44 AM
zosima,
chest tube to suck air from pleural cavity (it will not decomrese by himself like in tensionpneumo). your Q is very good! I could not find anything clear-cut, the refernces are blurry :"if is relative stabil", "CXR,place tube,connect to under watter seal" and also the naly in tension pneumo is emergency...!?! confused.. my problem here is that "Her airway is stable but auscultation reveals decreased breath sounds over the right lung field."in pneumo you don't have BS at all. anybody have a "clearer picture"? |
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