Parenchymal Hemorrhage Case Study

Chest tubes are used to drain fluid or remove air from the patient’s chest area. My patient had a chest tube to drain his pleural effusion 26mL

Mr. S was driving when he experience a stabbing chest and back pain for the first time. The pain was so severe he immediately went to his local ER. Pulmonary ventilation and perfusion (VQ) scan and Computed tomography angiography (CTA) was done at his local ER. VQ scan was negative for pulmonary embolism (PE). CTA of the chest revealed

The physician was notified of the pain and discomfort related to the chest tube, which pain medication was given. Other notifications were the amount of drainage from both the chest tube and the JP. Both were under normal limits. SOB and fatigue with activities were also notified to the

PLAN: I have reviewed the chest x-rays available here and agree with the finding of bleb formation in the right and left upper lobes. Despite the fact that the patient has had a high INR, because of his history of tuberculosis and hemoptysis I believe obtaining sputum for TB is very, very important. We should rule out any other endobronchial lesions as the cause for his bleeding. I have discussed this matter with the patient and his wife. I have told them that there is the possibility of observing the condition by x-rays and repeated tests of his sputum. They understand that this is an option; however, they decided that because of concern regarding his repeated hemoptysis, they would consent to bronchoscopy. We will arrange for the patient to have a bronchoscopy done. He is off Coumadin.

At CTPA study performed at the time excluded any pulmonary emboli and the report made comment of a moderate sized right-sided pleural effusion with compressive atelectasis. There was no comment on the report of any parenchymal infiltrate and I have not cited the images myself. CRP was 113. He was given a presumptive diagnosis of pneumonia with parapneumonic effusion and commenced an Augmentin Duo Forte and doxycycline. In

Pt received AP diameter X-ray to confirm tube placement and to see if there were any kind of infiltrates because of possible aspiration and to eliminate possible pneumothorax and pleural effusion. Findings included mild patchy infiltrates in the right upper to middle lobes. The left lower lobe also has some similar findings but less concerning. This may either be due to lung infection or pulmonary

J.M. is a 7-year-old girl that was involved in a high-speed MVA on 03/05/17. A semi-truck had rolled over the mini-van in which her, her parents, and her siblings where traveling in. When EMS arrived on the scene, all passengers had been extracted from the vehicle and J.M. had already been placed and was lying on a stretcher. Her father was found dead at the scene, her three other siblings were in critical condition, and her mother was transferred to CRMC. J.M. was then loaded onto an ambulance along with her other siblings and transported to VCH ED. Once J.M. arrived at VCH a head CT was performed and revealed a depressed comminuted frontal skull fracture. Six hours later a follow-up CT scan of the head was performed, which revealed a large intraparenchymal

A tension pneumothorax occurs when the lung is punctured, but there is no outside opening for air to escape. The pressure that builds is put on internal organs, which decreases cardiac output and the lungs’

A chest x-ray is the primary way to diagnose a pneumothorax. Generally two chest x-rays will be taken, one on inspiration and one on expiration. This allows to better visualize the collapsed lung. An additional CT scan may be required. Ultrasound may also be used.

Pt also has a history of deep vein thrombosis (DVT) with an inferior vena cava filter to capture any lose blood cells. The chest pain he is experiencing is no cardiac secondary to chest wall pain which is symptoms of his small cell carcinoma of the lung. Patient is required to use oxygen as needed for his SOB secondary to his lung cancer. No evidence of a compression fracture was found in the spine, patient has prior laminectomy postoperative changes in the lower lumbar secondary to previous falls.

There is no enlargement of the lymph nodes, pleural fluid or consolidation of a lung. There is no significance change in the appearance of the chest. The minimal subsegmental basal atelectasis is present. The compression fracture of a vertebra at the thoracolumbar junction, T12 or L1 is visualized. Radiographic images show atelectasis in lower part of the lung due to decrease amount of air in the alveoli resulting in volume loss and increase in density. The bilateral ribs are free of acute facture. There is no osseous expansile or destructive process. Pleural effusion or pneumothorax is rule out from this case

Hemorrhaging, some aged cuts opened back up on Frisk’s head and neck, maybe they reopened during eir sudden blackout. The bandages can only be reapplied so many times, after some contemplation, ey halfheartedly pulled at the swathes lining eir arms in a pile of red leaves. At the same time, a grotesque sight came rolling into view; scars, bright pink in contrast to eir white, but well-tanned skin, lining virtually every centimeter. Still, ey took the still surviving bandages and wrapped them around eir skull; in the end, ey ran out, however, it wasn’t enough. In light of this, eir scowl that formed during the process only became deeper, the only ones I have left are on my legs. In the end, ey started tugging at the layers of fiber around eir leg; only, ey came to see a scene even worse than eir arms.

Postpartum hemorrhage (PPH) is a significantly life-threatening complication that can occur after both vaginal and caesarean births (Ricci & Kyle, 2009). Simpson and Creehan (2008) define PPH as the amount of blood loss after vaginal birth, usually more than 500mL, or after a caesarean birth, normally more than 1000mL. However, the definition is arbitrary, attributed to the fact that loss of blood during birth is intuitive and widely inaccurate (Ricci & Kyle, 2009). In line with this, studies have suggested that health care providers consistently underestimate actual blood loss, thus, an objective definition of PPH would be any amount of bleeding that exposes a mother in hemodynamic jeopardy (Ricci &

Recent spirometry is also normal as is a chest x-ray. I note a CTPA performed in 2015 revealed a small basal effusion but no other abnormality of

Pleural infection is a frequent clinical problem associated to an elevated co-morbidity and considerable mortality rate and for these reasons the prompt clinical identifying is mandatory for the therapeutic way. The standard treatment includes broad spectrum and appropriate antibiotics and evacuation of infected pleural fluid (thoracentesis or tube thoracostomy). The appropriate management of complicated parapneumonic effusion or pleural empyema remains controversial. In the exudative stage is often effective the closed-chest drainage, but in fibrino-purulent phase, natural evolution of pleural infected fluid, this practice could not produce the expected results (as resolution of sepsis and complete parenchimal re-expansion) and then necessitates