Thursday, June 19, 2008

Spontaneous Pneumothorax

http://www.cssolutions.biz/Screens/ct_6.gifYoung male comes in to the ER with complaint of sudden onset right sided chest pain while doing an activity at work that involved strenuous use of his right arm. He was in a lot of pain in his right upper chest and right shoulder which was worse with position changes and deep inspiration. Based on my secondary exam and the doc's review, it seemed like we were looking at a muscle pull. I told him there was a slight possibility that he had a collapsed young given his profile of being a young, tall, skinny male who smokes, but that really I was gearing up to go get the L&I paperwork for him as soon as he got back from x-ray.

Needless to say, the chest tube tray is in a different location from the L&I paperwork. We knew it was a possibility, and had even warned him of such, but I would have thought the breath sounds would be absent on one side (granted they were certainly diminished, but I attributed that to smoking. My bad.

A couple hours later as we were getting to send him to med/surg, a young kid who was visiting him came up to me and asked in the most sober tone, "Can a short, skinny male get a collapsed lung, too?"

Image borrowed from C&S Solutions - cssolutions.biz via Google image search.

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