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10 Cards in this Set
- Front
- Back
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Size estimation of pneumothorax: Average interpleural distance technique
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- Sum of distance b/w the pleura surface at:
the apex middle of the upper half lung middle of lower half of lung - then divided by 3 1cm = 14% 2cm = 22 % 3cm = 31% 4cm = 40% |
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Size estimation of pneumothorax: British Thoracic sociey guildlines
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size of a pneumothorax is divided b/w lung margin and chest wall on PA CXR. (but did not say where to measure)
small <2cm large >2cm volume of 2cm is approximate to a 50% pneumonthorax |
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Size estimation of pneumothorax: American college of chest physicians
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distance from apex to the ipsilateral thoracic cupola at the parietal surface as determinded by an upright standard CXR
- small <3cm large > 3cm |
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Indication fo surgery after tube thoeacostomy (R&H 183)
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- massive haemothorax >1000-1500 ml initial drianage
- continue bleeding, >300-500 ml in 1st hr or >200ml.hr for first 3 or more hrs - increase size of pneumothorax on CXR - persistant haemothorax after 2X ICC placed - clotted haemothorax - large air leak preventing ventilation - persistent air leak after placement of 2nd tube or inablilty to fully expand lung |
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What are the bottles of the underwater drain bottle? (Dunn542)
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bottle 1 - connected to patient, acts as reservoir to collect blood (2200ml in 3 colums)
bottle 2 - underwater seal bottle 3 - suction bottle bottle 4 positive pressure pop up chamber |
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Complication of ICC (Dunn 541)
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- haemorrhage
- bronchopleura fistula - surgical emphysema misplacement (extrathoracic, subcutaneous) - Damage to lung, NVB, mediastinal content, myocardium ...) - infection (empyema rate 1%) - failure to expand - persistent air leak - re expansion pulmonary oedema |
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Recurrance of spon PTx: (Cameron 306)
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- recurrance rate 50%, half occur in 4 months, this increases to 60-70 % for subsequent recurrence
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Preceipitants for Pneumomediastinum: (Dunn534)
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- valsalva manoeuvre
- asthma - sports activitivites - vomiting - coughing - inhalation of illegal drugs (e.g. cocaine, ecstasy, amphetamines) |
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Boerhaave syndrome (D534)
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- mortalitiy 30-50%
typicially occurs after vomiting rupture of oesphageal wall classical triade of severe chest pain, subcutaneous emphysema following vomiting Hammans sign elevated of inflammatory markers, CXR - Pneumomediastinum + pleura effusion |
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Hamman's cruch?
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Crackles heard in scynchrony with cardiac cycle - suggest mediastinal emphysema
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