Diagnostics and Therapeutics: Managing Pneumothorax

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Diagnostics and Therapeutics: Managing Pneumothorax

There are many different types of pneumothorax (PTX), and the management paradigm has shifted in recent years as the research has exploded on this topic. This topic is additionally complicated by the development of multiple diagnostic tools now available for diagnosis as well as variable sizing algorithms used around the world. Institutional resources and specialty services may further dictate the management of PTX. This post aims to broadly cover the types of PTX, the diagnostic modalities available, and the ideal management by PTX type in the Emergency Department.

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Grand Rounds Recap 9.27.23

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Grand Rounds Recap 9.27.23

It was a stellar week here at UCEM Grand Rounds! We kicked off the day with a lecture from our colleague at CCHMC, Dr. Dean, about management of pediatric airways. We then transitioned to a review of landmark studies in EM, specifically with regards to targeted and systemic thrombolysis for MI, stroke, and PE. We continued our day by discussing evidence based medicine and the implementation of this in the prehospital setting with EMS faculty, Dr. Richards. Next, Drs. de Castro and Thompson faced off in an epic battle of CPC where we covered the diagnosis and management of euglycemic DKA. This was then followed by Dr. Vaughan’s R1 diagnostics and therapeutics lecture on pneumothoracies. Finally, we wrapped up the day with Dr. Gillespie’s R4 capstone lecture.

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Tube Thoracostomy for Hemothorax - Is a Tiny Tube Just Fine?

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Tube Thoracostomy for Hemothorax - Is a Tiny Tube Just Fine?

In this Journal Club podcast, PGY-3 Tony Fabiano breaks down a paper from the Journal of Trauma comparing the effectiveness and patient perception of pigtail catheters versus standard chest tubes for hemothorax in the setting of trauma. Is a tiny tube effective at all in draining blood from the chest?

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Grand Rounds Recap 6.8.22

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Grand Rounds Recap 6.8.22

Another great week of Grand Rounds including pneumothorax therapeutics with Dr. Sardis Harward, snake bites with Dr. Mel Otten, Ventricular and Junctional Escape Rhythms with Dr. Dave Jackson - QIPS and Patient Safety with Dr. Dave Thompson, Wellness and On-Shift Nutrition with Dr. Roblee and the Wellness Team and finally The Crashing Neonate with the Cincy PEM Team!

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Lung Ultrasound: Evaluation for Pleural Fluid and Pneumothorax

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Lung Ultrasound: Evaluation for Pleural Fluid and Pneumothorax

The Basics

Think about gravity: fluid will collect in most dependent region (down); air tends to collect towards the least dependent regions (up)

Air does not reflect sound waves well. Lungs are filled with air. Rather than getting most of our information from visualizing the anatomy (as in a RUQ ultrasound, for example), much of our information comes from “artifact” or ultrasound waves being affected by phase changes.

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