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Pleural Effusions, Thorcentesis, Chest Trauma & Pneumothorax - Coggle…
Pleural Effusions, Thorcentesis, Chest Trauma & Pneumothorax
Pleural Effusion
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Transudate = Heart failure, pulmonary embolism, cirrhosis, post open heart surgery
Exudate= pneumonia, cancer, pulmonary embolism, kidney disease, inflammatory disease, TB, bleeding (trauma)
S&S: breathless, dry cough, chest pain, orthopnoea, asymmetrical movement of chest wall, decrease in speech vibrations on one side of the chest wall, dull sounds on one side of the chest wall
Diagnosis= CXR, CT of chest, ultrasound, thoracentesis, pleural fluid analysis
Treatment: treat the cause, thoracentesis/pleural aspiration, chest tube, insertion of sclerosing agent to cause scarring
Thoracentesis
invasive procedure, fluid is removed from pleural space with a needle.
Aspirated fluid analysed for appearance, cell counts, protein/ glucose content, the presence of enzymes, abnormal cells & culture
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Complications= Pneumothorax, infection, cardiovascular collapse
Sitting upright, leaning forward with arms & head supported on over bed table
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Ribs
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Top 3 ribs associated with laceration of the subclavian artery & vein. Lower ribs associated with injury to spleen & liver
Treatment; majority benign & treated conservatively, pain management, monitor pulmonary status, takes 3-6weeks to heal
Flail chest
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During inspiration & expiration detached part of rib segment move in a paradoxical manner to the rest of the ribcage
Treatment: Mild= resp. support, clear secretions, control pain
Severe= ventilate
Pneumothorax
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Haemothorax = blood in pleural space. Hemopneumothorax= air & blood in pleural space caused by trauma, surgery, disease
Open pneumothorax= air enters & leaves the pleural space on inspiration & expiration usually follows blunt instrument trauma
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