Tritsch Zachary, Galan Gayle, Oates Gary, Thomas Janelle
Marietta Memorial Hospital, Department of Emergency Medicine, Marietta, OH.
J Educ Teach Emerg Med. 2021 Jan 15;6(1):V26-V28. doi: 10.21980/J8ZD1S. eCollection 2021 Jan.
This case demonstrates the importance of quickly identifying a pediatric patient in acute respiratory distress secondary to pneumothorax and highlights the emergent management of these patients. The 16-year-old male patient presented to the emergency department (ED) with a chief complaint of right-sided rib pain and shortness of breath that began acutely after an all-terrain vehicle (ATV) accident. The patient was in respiratory distress upon presentation and had diminished right-sided breath sounds. A portable chest X-ray demonstrated pneumothorax with significant mediastinal leftward shift. Needle decompression of the right chest wall was performed and right sided thoracostomy was placed. It is important to maintain a high index of suspicion for tension pneumothorax in pediatric trauma patients with respiratory distress, even when hemodynamically stable. This case report discusses proper management of traumatic tension pneumothorax and discusses current recommendations for needle decompression and thoracostomy.
Tension pneumothorax, pediatrics, respiratory distress, portable chest x-ray, ultrasound.
本病例展示了快速识别继发于气胸的急性呼吸窘迫小儿患者的重要性,并突出了这些患者的紧急处理。一名16岁男性患者因全地形车(ATV)事故后急性出现的右侧肋骨疼痛和呼吸急促为主诉就诊于急诊科(ED)。患者就诊时处于呼吸窘迫状态,右侧呼吸音减弱。便携式胸部X线显示气胸伴纵隔明显向左移位。对右侧胸壁进行了针减压并放置了右侧胸腔造口术。对于有呼吸窘迫的小儿创伤患者,即使血流动力学稳定,也必须高度怀疑张力性气胸。本病例报告讨论了创伤性张力性气胸的正确处理,并讨论了针减压和胸腔造口术的当前建议。
张力性气胸、儿科、呼吸窘迫、便携式胸部X线、超声