Tension Pneumothorax-ccs - csa118

[ArchivalUser]

Hi,
the usmle cd case looks like end with the needle thoracostomy and tube.check x-ray again.
do we need put reasure ,counseling advice seat belt safety .
i think it's finished before translocated to ward.is it correct?

[ArchivalUser]

If you have time, it is better do every thing, I think they want that we management the cases until the patient is dischard and then follows the patients as possible.

[ArchivalUser]

thank you so much artepupila
you explaination is so great .i will organize other case and please give me suggestion.because iam going to take test next monday.Thanks

[ArchivalUser]

ok, I will be glad, actually I'm going to take my test in 2 weeks, if you want, we can practice each other.

[ArchivalUser]

Hi,artepupila
here is the case of tension pneumothorax,Please correct for me

oxygen
pulse oxm
cardi monitor
bloold pressure monitor
intrave access
normal saline
elevate head

physical exam
chest x-ray
needle thoractomy
tube thoractomy
chest x-ray again(show inflated lung)
morphine(iv one bolus)

ecg
cbc
bmp
pt/ptt
consult thoracic surgery(suggestion present medical treatment)

translocated to ward

bedrest complete
urine output
pneumatic stock
vital sigh
morpnine (im one bolus)

advance clock already finished

reassure patient
counseling patient
no smoking
no alcohol
safe seat belt
no illegal drug

dignosis(Tension pneumothorax)

[ArchivalUser]

very good, may be when you admit the patient, you can change the analgesic to IV ketorolac if the patcient need it. Actually I'm going to read alittle more about it.

If anyone else would share with us?

[ArchivalUser]

by the way, we can complet thii add, Diet, respiratory Physiotherapy, deep breath, vaccination if the patient is at high risk, etc

[ArchivalUser]

Hi,artepupila
I think the respiratory physiotherapy good.
Do you think when we should D/c the tube (if patient improve).the other thing is do we need abg?

[ArchivalUser]

The ABG is important, when the patient is ok, normal RR, totaly expanded

[ArchivalUser]

Hi csa118 and artpupila

Do we not shift the patient to ICU first and once the patient contion improves take cxray and take off the chest tube and then shift to ward and observe for and once stable discharge.
One more thing when do you consult before tube thoracotomy or after. do we go for thoracic surgry or pulmnology consult
please do clarify