Chest tubes

Accident cases are happening all the time, and serious cases like pneumothorax are not uncommon recently. 

I had just inserted a chest tube last week, and this week another patient came with pneumothorax which requires chest tube insertion.

This patient is referred from a district hospital, sustained multiple jaw-dropping injury like extra-dural hemorrhage, shaft of femur fracture, and bilateral pneumothorax.

The initial Chest X-ray only noted left sided pneumothorax with lung collapsed, chest tube was inserted in the district. 

However, repeated Chest X-ray noted there is expansion of pneumothorax over the right side too, albeit not obvious to the naked eye.

We managed to pick up the findings when we perform eFAST on the patient. The presence of 'lung point' on the right side prompt us to have a closer look on the 2nd Chest X-ray, which if observed closely, a rim of >2cm is present. 

Thus, I inserted the chest tube with Oscar who is the surgical MO oncall. It was quite a good learning process as both of us are still learning and are juniors in procedures like these. 

Take home message: eFAST scan saves life!