Monday, July 16, 2007

VizD Challenge Week of 7/16/2007

A 24-year-old man is brought to your Emergency Department after being stabbed in his chest. His heart rate is 125 beats per minute, respiratory rate is 33 breaths per minute, and blood pressure is 85/50 mm Hg. You note the findings seen in the images below.



(click on image to enlarge)
Questions:
1. What is the presumed clinical diagnosis?
2.
What is the immediate treatment?
3.
What is the definitive treatment?







Winner receives $10
To submit your answer please click on comments below.
For more information about the contest, click here.




VizD is a weekly contest of an interesting or pathognomonic image from emergency medicine. Its goal is to integrate learning into a fun and relaxed environment. All images are original and are posted with the consent of the patient. For more information please refer to the following link.

10 comments:

Julia Malin said...

1) Cardiac tamponade

2) Needle pericardiocentesis

3) Pericardial window - surgical procedure

Juliamd

runninggirl@mac.com said...

1. Tension pneumothorax.

2. 100% oxygen + emergency needle decompression.

3. Thoracostomy tube.

Anonymous said...

Tension pneumothorax.
Needle decompression.
Chest tube.

Kev said...

1. Tension pneumothorax
2. needle thoracostomy- needle decompression
3. tube thoracostomy- chest tube

Parameddan said...

1. Pericardial Tamponade

2. Fluids to increase BP with an emergent pericardiocentesis.

3. surgical pericardiectomy

Anders Krogh Vistisen, Denmark said...

1: Tension Pneumothorax
2: Needle Decompression
3: Chest Tube

Anonymous said...

1. tension pneumothorax
2. needle decompression
2. thoracostomy

inna leybell
:)

Anonymous said...

Tension pneumothorax
Place needle or jelco in 2nd ICS, MCL
Chest tube


CardioNP

David said...

1)presumed diagnosis is hemopericardium causing tamponade (low BP, JVD)
2) immediate treatment is to bolus IV fluids and maintain cardiac output while setting up for definitive treatment which is...
3) a pericardiocentesis or pericardial window to drain the hematoma and relive the pressure aroudn the heart

Sarah said...

1) tension pneumothorax
2) 14 gauge angio cath in second intercostal space, midclavicular line on side trachea is deviated away from/has no breath sounds
3) definitive treatment is chest tube to suction