THE INSERVICE IS TOMORROW Bored Review!

You see an 18 year old basketball phenom who stands a mere 6’11” tall. He complains of sudden onset chest pain lasting minutes after a deep inhalation that may or may have been related to marijuana use. On his chest x-ray, you see a “small” pneumothorax.

What is the definition of a SMALL pneumothorax

Depends a little on your source – ≤3 cm from the thoracic apex to lung cupola versus <2 cm from the thoracic apex to lung cupola.

What is the appropriate treatment and dispo?

OXYGEN! It decreases the time to re-expansion. Without O2 – 1.25% pneumothorax reduction per day. WITH O2 – 5% reduction per day. The patient would likely need admission with serial X-rays to ensure the pneumothorax does not expand.

By Dr. Andrew Grock and Dr. Sally Bogoch

References

Tintinalli’s 7th ed