CASE STUDY NH4.1
You respond to an asthmatic patient in your clinic who is in severe respiratory distress. His condition requires intubation. While providing assisted ventilation using a bag-valve device, you begin to feel significant resistance to your squeezing of the ventilation bag. Simultaneously, you observe that the patient is becoming cyanotic. When you check for a pulse, there isn’t one. You observe the following on the ECG monitor:
You immediately auscultate the chest and fail to hear any breath-sounds on the right side of the chest. However, you can hear clear left-sided breath-sounds. You quickly percuss the chest and the right side is noticeably tympanic. You insert a 14-gauge angio-cath between the 2nd and 3rd rib, at the mid-clavicular line. There is a sudden rush of air through the angio-cath. You can feel an immediate reduction in the resistance when squeezing the bag. You also see the patient’s color improving and he is beginning to breathe on his own. You have called 911 for transport to the hospital. You learn the next day that the patient had a right-side chest tube inserted and is doing well.