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  scorpion - 10/31/06 15:27
  65/M presents to ER with excruciating R chest pain. Patient in Respiratory distress.

Vitals: T 37 PR 120 RR 34 100/60 . Patient not able to talk cos of pain.

Wat will u do first

Pulse oxymetry, CXR, CBC for platelets, PT/PTT ……then go in for chest tube?


Chest tube straight away…

Exam case.. Apt suggestions required guys…how will u approach this case…how will u advance this case…cos der is interim history which is available in the history….

Interim H/o father Died MI 45, patient asthmatic, chronic bronchitis, on non prescription drugs…..

The past history comes in the middle of the case….

Il be very happy if someone discusses this case in detail…

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  nicke - 10/31/06 16:06
  first of all i think we need to do
quick chest and cvs exam
pulse ox

cardiac monior
and if on PE we suspect tension pneumo tx
needle thoracotomy
chest xray
cardiac enzymes
and rest will depend on the findings that we will get from softwear that its a case of cardiac pr pulmonary pathology!
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  scorpion - 10/31/06 16:33
  k ...u take all the precautions for confirming the diagnosis and u put in a chest tube!!
do v have to check the platelets and the BT, B4 v proceed.

u do put the chest tube...patients is releived...check CXR shows the lung has expanded...When will u remove the chest tube.?...When will u shift the patient to the ward...and wat tests do u wanna do the patient b4 v discharge him...Counseling?

How wil u go abt his asthma and chr bronchitis?
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