Category: Fundamentals The heart's ability to increase the rate of a normal sinus rhythm is primarily related to age: the maximum HR possible with a sinus tachycardia is approximately 220 beats/min minus age, with normal variations as high as 10 to 20 beats/min.
Category: Fundamentals Normally, the human heart beats at approximately 80 beats/min (± 20 beats/min). If the heart rate exceeds 100 beats/min, it is called tachycardia. If it drops below 60 beats/min, it is called bradycardia.
Category: Fundamentals Treatment is different for patients with a secondary spontaneous pneumothorax. In patients with chronic obstructive pulmonary disease, malignancy, cystic fibrosis, pneumonia and tuberculosis, a chest tube usually cannot be avoided.
Category: Fundamentals With no intervention, a small pneumothorax will resolve over a period of days to weeks. Supplemental oxygen will speed the process of lung reexpansion by increasing the rate of pleural air absorption.
Category: Fundamentals Chest tube placement is probably not necessary in healthy patients with small primary spontaneous or isolated small traumatic pneumothoraces in the absence of respiratory compromise or concomitant injuries.
Category: Fundamentals Supraventricular tachycardias are classified as narrow-complex (QRS duration < 0.12 second) and wide-complex tachycardias (QRS duration > 0.12 second). The rhythms of these dysrhythmias can be regular or irregular.
Category: Fundamentals The gold standard for pneumothorax diagnosis is a thoracic CT scan, which can even detect a pneumothorax that is not easily visible on a plain radiograph. CT scans are much more sensitive than plain radiographs in detecting pneumothorax.
Category: Fundamentals During the initial phase of resuscitation (airway, breathing, circulation, disability), consideration for the diagnosis of pneumothorax should be considered in patients who are tachycardic, hypotensive and dyspneic.
Category: Fundamentals Tension pneumothorax must be considered in any patient with sudden or severe respiratory or cardiac deterioration and in intubated patients who become difficult to ventilate. Signs include increased airway pressure and hypotension.
Category: Fundamentals An empyema is an accumulation of pus in the pleural space, usually from a parapneumonic infectious effusion. An empyema can also be caused by violation of the thoracic space during surgical procedures, trauma and esophageal perforation.
Category: Fundamentals A tension pneumothorax is usually caused by penetrating chest injuries but can also result from fracture of the trachea or bronchi, a ruptured esophagus and the presence of an occlusive dressing over an open pneumothorax.
Category: Fundamentals A tension pneumothorax occurs when an injury creates a one-way “flap valve” mechanism that allows air into the pleural space with inspiration but then closes with expiration and traps the air.
Category: Fundamentals An open pneumothorax occurs when the chest wall is penetrated and the negative intrapleural pressure is lost. Each breath can increase intrapleural pressure, especially if the diameter of the wound is greater than the diameter of the trachea.
Category: Fundamentals Closed pneumothorax usually occurs from a rib fracture that penetrates the lung, but can also occur when an alveolus or bleb ruptures after blunt trauma. The air leak is generally self-limited but can progress to a tension pneumothorax.
Category: Fundamentals Spontaneous pneumothorax is caused by the rupture of a subpleural lung bleb with little or no trauma and can be categorized as either primary or secondary based on the presence of underlying lung disease.