Intercostal chest drains (ICD) are used for therapeutic purposes to remove air and/or fluid from the pleural space (e.g. pneumothorax and haemothorax in trauma cases). ICD insertion is a complex procedure that should only be carried out by trained practitioners with skilled assistance, and trainees must perform it under supervision until competent. Contraindications Complications Complications include
Although as an FY1/2 you wouldn’t be expected to insert a chest drain yourself but you will often be called out of hours to review a drain for a variety of reasons: Not swinging/bubbling Not draining Painful “It needs flushed and I don’t do that” Indications for a chest drain: (BTS guidelines) Tension pneumothorax or
In the webinar below, Dr Dexter Valencia (interventional radiology registrar) provides a structured approach to CT chest/thorax interpretation, with an overview of common cases & pitfalls.
As a foundation doctor, shortness of breath is one of the commonest symptoms you can encounter on the acute take. Causes of shortness of breath are very broad but in this session, we will discuss pleural effusion. The management will vary depending on the causes of pleural effusion, therefore the diagnostic approach is important. The
Bronchiectasis is a chronic respiratory condition characterised by the irreversible widening and scarring of the bronchi, leading to recurrent infections and a decline in lung function. While relatively rare, bronchiectasis can be a debilitating condition that severely impacts a patient’s quality of life. It is important to recognise the signs and symptoms of bronchiectasis, as
A pneumothorax is defined as the abnormal collection of air between the visceral and parietal space of the lung i.e. the pleural space. It typically presents with acute shortness of breath, pleuritic chest pain and is more common in those with damaged or stretched lungs. Despite clear cut guidelines from BTS, real-life management varies considerably
A pulmonary embolism (PE) is a blocked blood vessel in your lungs, most often due to a blood clot. It is common and can be asymptomatic but can be life-threatening if the clot is large and near the centre of the lung. With a massive PE immediate management is necessary. Causes A common cause of
In this article, we will focus on more practical concerns when managing a patient with pneumonia for resident doctors. Covid-19 is not discussed here. History Basics: fever, productive cough with yellow-green sputum, shortness of breath & pleuritic chest pain In the context of patients with underlying respiratory disease, ask what about the sputum & SOB
As an FY1, you will be called to review patients who are hypoxic. Here we will discuss common causes of generalised hypoxia rather than focal hypoxia/ischaemia, such as in strokes or heart attacks. Also, insufficient oxygen-carrying capacity due to anaemia or ineffective use of oxygen at the tissue level (no cyanide management here zebra hunters!)
Non-invasive ventilation (NIV) is a way of providing ventilatory support to patients in respiratory failure without using an invasive airway device (e.g. endotracheal, naso-tracheal or tracheostomy tube). Careful use of these, have been shown to not only reduce the need for invasive ventilation, in acutely unwell patients, but also improve mortality rates. The devices are
