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Tension Pneumothorax

  • A patient who came with history of fall while boarding a running local train under effect of alcohol
  • He was brought to the hospital after 2 hours of injury by the local police 
  • When he came he was very restless and agitated
  • There were no signs suggestive of any head injury
  • Only sign we were able to elicit was marked tenderness over Right side of chest
  • There were no obvious dilated veins over the neck, though a slight tracheal deviation was present
  • A chest xray showed
    • -Over expanded Right hemithorax
    • -Shift of the mediastinum to the left side
    • -Depression of the Right hemidiaphragm
  • SPO2 was 78%. Immediately a needle thoracostomy was done. The SPO2 increased to 94%.
  • An intercostal drain with under water seal was inserted.

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