Ice packs

Case contributed by Yaïr Glick
Diagnosis certain


Found in his car in a stuporous state on a very hot day, AC turned off.

Patient Data

Age: 80 years
Gender: Male

Moderate-sized right pneumothorax.
Fractures in 2nd and 3rd right ribs.
Properly placed tracheal tube, NGT descends into the stomach.
Rows of delicate surgical clips in the mid and lower zone of the left lung - segmentectomy?
Ice packs are placed on both sides of the chest wall.

Case Discussion

Meant to take his car for a checkup and was found stuporous in his car in another city. The car was closed with no AC on an extremely hot day. Received resuscitation from an ambulance team, with the return of pulse. Arrived at the ER ventilated, with hyperthermia, complete AV block, and hypotension.

The chest x-ray shows a moderate right pneumothorax, most probably due to 2nd and 3rd right rib fractures sustained during the initial CPR. Ice packs were placed to treat the hyperthermia, as were cold fluids administered via a venous line, an NGT, and a urinary catheter.

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