Spontaneous Pneumothorax; Roadside to Resus

10/16/23 • 41 min

In this episode we’re going to cover the ‘atraumatic’ or ‘spontaneous’ pneumothoraces and focus on some new key guidelines from the British Thoracic Society which came out in July this year and also look at the relevant evidence on the topic.

There are pretty significant changes in the BTS guidance, it’s no longer about finding a pneumothorax, working out if it’s primary or secondary and then acting dependant on the size. It's now moved more towards looking at how the patient is clinically, taking into account the symptomatology, any big risk characteristics, whether it’s primary or secondary and then thinking about the patients wishes and priorities and nuancing the management plan towards those.

This episode builds on some of the concepts we discussed in our Traumatic Pneumothorax podcast, so make sure you give that one a listen before clicking play on this one!

We'll be looking at the presentation, evidence, management and follow up, along with some trials that you can get involved in to help develop practice even further.

Once again we'd love to hear any comments or questions either via the website or social media.

Enjoy!

Simon, Rob & James

This episode builds on some of the concepts we discussed in our Traumatic Pneumothorax podcast, so make sure you give that one a listen before clicking play on this one!

We'll be looking at the presentation, evidence, management and follow up, along with some trials that you can get involved in to help develop practice even further.

Once again we'd love to hear any comments or questions either via the website or social media.

Enjoy!

Simon, Rob & James

Previous Episode

October 2023; papers of the month

Welcome back!

This month we kick off looking at an RCT which looks at whether we should convey patients with a ROSC from a likely cardiac cause (without a STEMI in their ECG) to a cardiac arrest centre, or whether they would be as well served at their local Emergency Department. This paper has huge potential implications for service design for cardiac arrest patients.

Next up we look at another RCT evaluating if patients with a suspected uncomplicated appendicitis who have urgent surgical intervention benefit in terms of a reduced perforation rate, when compared with those who have surgery within 24 hours.

Lastly we take a look at the use of bicarbonate, calcium and magnesium in cardiac arrest and see if there use is supported in a huge cardiac arrest registry.

Once again we’d love to hear any thoughts or feedback either on the website or via X @TheResusRoom!

Simon & Rob

Next Episode

November 2023; papers of the month

Well this has been a huge month for Emergency Medicine and Critical Care in terms of papers!

We start off looking at REBOA; many resuscitationist's favourite concept or device with the much awaited UK-REBOA trial. What does the paper mean for practice in our Resus Rooms? Is this about to become a key part of trauma management? The paper is fascinating and one of the most though provoking we've discussed in a while.

Next up we look at CROYSTAT-2, another such anticipated trial looking at whether survival could be improved by administering an early and empirical high dose of cryoprecipitate to all patients with trauma and bleeding that required activation of a major hemorrhage protocol.

Finally we look at a paper which describes a taxonomy of key performance errors in intubation and may inform our review and improvement of intubation in the ED.

Once again we’d love to hear any thoughts or feedback either on the website or via X @TheResusRoom!

Simon & Rob