Distended

Respiratory System


0

{"ops":[{"insert":{"image":"\/storage\/case-images\/cs\/S20_F1.jpg"}},{"insert":"\n\n"},{"insert":"You smile at the irony of the song playing on the radio, as you drive to your job as an ER physician.\r\n\r\n\u0022Stayin\u0027 alive! Stayin\u0027 alive! Ha! Ha! Ha! Ha! Stayin\u0027 aliiiive. . . . \u0022 you belt out the words, keeping perfect rhythm.\n\nAfter successfully finding a parking space, you enter the hospital and greet your coworkers in the emergency room.\n\nA nurse hands you a chart, and you start acquainting yourself with your first patient of the day, Mr. Silva.\n"}]}

1

{"ops":[{"insert":{"image":"\/storage\/case-images\/cs\/S20_F2.jpg"}},{"insert":"\n\n"},{"insert":"As you briefly look over the chart you learn that Mr. Silva is 53 years old and that he was brought to the ER by his son David this morning, with the chief complaint of sudden onset dyspnea.\n\n\u0022Hello Mr. Silva, I\u0027ll be taking care of you today,\u0022 you start off. \u0022How are you feeling?\u0022\n\nYou note that Mr. Silva is having difficulty answering your questions and that he appears increasingly more dyspneic, diaphoretic, and cyanotic.\n\nYou quickly note that the cardiac monitor reveals a heart rate of 134 bpm, with a blood pressure of 100\/60 mm Hg, respirations of 24 cpm, and an oxygen saturation of 87%, while on 35% oxygen via a nasal cannula.\n\nOn the physical exam, you note that he has distended neck veins and that his trachea is deviated to the right.\r\n \r\nThe left thorax does not expand upon inspiration, is hyper-resonant on percussion, and breath sounds are absent on auscultation.\n\nYou make eye contact with your nurse who states, \u0022This patient is deteriorating rapidly, doctor.\u0022\n"}]}

6

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4

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5

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3

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