Round 12 (Difficulty Breathing)

CAUTION: THESE NOTES CONTAIN SPOILERS!!!











Case Introduction











A young gentlemen runs out to triage yelling “I can’t breath!” and collapses to the floor in front of the nurse…











Initial Vitals











* Temp 98.8* HR 145* RR 45* BP 60/30* O2 85%











Critical Actions











* Give Supplemental Oxygen* Identify Pneumothorax Prior to Imaging* Correctly Perform Needle Thoracostomy* Correctly Perform Tube Thoracostomy











Final Diagnosis











Pneumothorax Secondary to Penetrating Chest Trauma











Tips and Tricks











Be careful, lack of visual cues during oral cases can mislead you!











Additional Reading











* Thoracic Trauma (EM Clerkship)* NBME Trauma Review (EM Clerkship)