Presentation
Verified COVID-19 patient, unvaccinated, with moderate-to-severe respiratory symptoms. History of asthma.
Patient Data
Age: 50 years
Gender: Female
From the case:
Tension pneumothorax
{"current_user":null,"step_through_annotations":true,"access":{"can_edit":false,"can_download":true,"can_toggle_annotations":true,"can_feature":false,"can_examine_pipeline_reports":false,"can_pin":false},"extraPropsURL":"/studies/110058/annotated_viewer_json?_c=1698060106\u0026iframe=true\u0026lang=us"}
Alveolo-interstitial infiltrates, with peripheral and lower zone predominance.
{"current_user":null,"step_through_annotations":true,"access":{"can_edit":false,"can_download":true,"can_toggle_annotations":true,"can_feature":false,"can_examine_pipeline_reports":false,"can_pin":false},"extraPropsURL":"/studies/110059/annotated_viewer_json?_c=1698060106\u0026iframe=true\u0026lang=us"}
Properly placed endotracheal tube.
{"current_user":null,"step_through_annotations":true,"access":{"can_edit":false,"can_download":true,"can_toggle_annotations":true,"can_feature":false,"can_examine_pipeline_reports":false,"can_pin":false},"extraPropsURL":"/studies/110060/annotated_viewer_json?_c=1698060106\u0026iframe=true\u0026lang=us"}
Right chest drain inserted at axillary line between 5th and 6th ribs, its tip projected between anterior arches of 3rd and 4th ribs, appearing too deep (abutting the pleura). Mild subcutaneous emphysema around point of drain insertion.
{"current_user":null,"step_through_annotations":true,"access":{"can_edit":false,"can_download":true,"can_toggle_annotations":true,"can_feature":false,"can_examine_pipeline_reports":false,"can_pin":false},"extraPropsURL":"/studies/110061/annotated_viewer_json?_c=1698060106\u0026iframe=true\u0026lang=us"}
Chest drain has been pulled out a bit.
Case Discussion
COVID-19 patient crashed and required endotracheal intubation for mechanical ventilation. Rapidly developed tension pneumothorax, most likely due to barotrauma. A chest drain was inserted, with expansion of the right lung.