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em@3am

EM@3AM: Pneumothorax

A 30-year-old male presents after a motor vehicle accident with chest pain and shortness of breath. He is alert, speaking in 1-2 word responses, and appears in moderate respiratory distress. He has normal left sided breath sounds, but none on the right. No lung sliding is seen with ultrasound examination of the right thorax. His trachea is deviated left, and increased JVD is noted. What is this patient’s presentation consistent with? What is your next step in management?

EM Cases

EM Cases – Community Acquired Pneumonia: Emergency Management

While community acquired pneumonia (CAP) is ‘bread and butter’ emergency medicine, and the diagnosis is often a ‘slam dunk’, it turns out that up one third of the time, we are wrong about the diagnosis; that x-rays are not perfect; that blood work is seldom helpful; that not all antibiotics are created equal and that deciding who can go home and who needs to go to the ICU isn’t always so clear cut.