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Notes for pneumothorax:

Simple > chest tube

Open > 3 sided dressing

Tension > decompression

17:10

Pneumothorax

Simple(unstable or large) > chest tube thoracostomy

stable/small > aspiration

Open > 3 sided dressing

Tension > needle thoracostomy decompression > chest tube thoracostomy

Hemothorax > thoracostomy tube > if 1500 on initial or >200/h for 4hrs > Thoracotomy

17:17

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17:49

Pneumothorax

Hunter SMLE MCQs discussion 03.09.2022 21:47:43

12- COPD patient developed sudden symptoms of spontaneous pneumothorax, x ray was done and showed 2 cm pneumothorax, mx?

A. Needle

B. Chest tube

C. Observation

17:49

Pneumothorax

COPD patient developed sudden symptoms of spontaneous pneumothorax, x ray was done and showed 2 cm pneumothorax, mx?

A. Needle

B. Chest tube

C. Observation

D. Aspiration


Still, I would go with B. bullae rupture as one of the complications of COPD. Moreover, the pt is not Asymptomatic. But if the pt is asymptomatic, then the answer C is not right because we need to give O2 for at least 6h and observe the pt so D is more reasonable for asymptomatic pt. "UTD"

17:50

he management depends on the patient stability + size



Unstable -> Chest tube


Stable + mild symptoms or size less than 3 cm from apex -> observation with or without O2


Stable + severe symptoms or size more than 3 cm from apex -> aspiration or chest tube

24 September 2022

16:28

Pneumothorax

Hunter SMLE MCQs discussion 22.09.2022 20:22:00

743- Tall man has spontaneous pneumothorax after landing from airplane has dyspnea absent Rt lung sound did CXR Rt pneumothorax no pics what’s the initial management? No size or site mentioned

A- chest thoracostomy

B- chest tube

C- observation

D- irrelevant

16:28

Pneumothorax

would go with B. absent lung sound means large pneumothorax. if unstable A. but he is stable. observation always wrong answer, because it must be associated with O2 supplemental O2 then observe for 6 h.

26 September 2022

18:32

Pneumothorax

SMLE Surgery 13.09.2022 11:26:16

✅️✅️

#trauma

#pneumothorax


Traumatic patient presented to ER with Profuse bleeding from nose and mouth , cyanosed with decreased breath sound on right side of the chest. Mostly was unstable Which of the following is the most appropriate next step.


A-Right chest thoracostomy


B-Intubation


C-IV fluid resuscitation and O type blood transfusion.

18:32

SMLE Surgery 13.09.2022 11:33:14

Appropriate Answer is needle decompression.


This is most likely traumatic pneumothorax.


First, decompress then chest tube.


Among these choices, answer is A


Intubate patient with pneumothorax after relieving it, as Positive-pressure ventilation following intubation will exacerbate a pneumothorax.

19:15

Pneumothorax

Hunter SMLE MCQs discussion 09.09.2022 19:33:44

Patient after trauma have shortness of breath and decrease air entry in left lobe and the left lung was hyper resonant to percussion. What is the next step?

A. Chest tube in left side.

B. Needle decompression.

C PA, lateral chest x ray.

19:15

Pneumothorax

Alwbidie chose A and this his explaination

19:18

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19:19

Simple(unstable or large) > chest tube thoracostomy

stable/small > aspiration

Open > 3 sided dressing

Tension > needle thoracostomy decompression > chest tube thoracostomy

19:23

Unstable/cyanosis/jvp/= tension pneumothorax = Needle decompression > chest tube

28 September 2022

17:40

Pneumothorax

SMLE Surgery 10.08.2022 11:49:01

#trauma

✅✅


A 50 year old sustained blunt trauma to the chest with persistent pneumothorax and significant air leak through double intercostal tubes ( ICT ) . Which of the following is the most appropriate next procedure ?


A.Reposition of ICT


B.Prompt thoracotomy to treat


C. Endotracheal intubation


D.Fiber - optic bronchoscopy to diagnose

17:40

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