Podcast 704: Treatment of Pneumothorax

Podcast 704: Treatment of Pneumothorax

Contributor: Adam Barkin, MD

Educational Pearls:

  • Multi-center open-label non-inferiority trial looked at treatment of pneumothorax with a small-bore chest tube versus conservative management with exceptional follow up
  • 316 patients ages 14-50 with moderate to large pneumothorax (>32% measured on CXR) were randomized into one of the two treatment arms
  • 15% of the conservative group required further intervention as determined by prespecified protocols
  • 94.4% of the intervention group had resolution at 8 weeks, whereas 98.5% of the conservative group had resolution at 8 weeks
    • These data were affected by poor follow up
  • CXR resolution average of 16 days in the intervention group and 30 days in the conservative group
  • Symptom resolution was similar between the two groups (median 15 days vs. 14 days)
  • Recurrence at 12 months was 17% in interventional group vs 8% in conservative group
  • 41 adverse events in intervention group and 13 adverse events in conservative group

References

Brown SGA, Ball EL, Perrin K, et al. Conservative versus Interventional Treatment for Spontaneous Pneumothorax. N Engl J Med. 2020;382(5):405-415. doi:10.1056/NEJMoa1910775

Franzen, D. (2019, November). Pneumothorax. Society of Academic Emergency Medicine. https://www.saem.org/about-saem/academies-interest-groups-affiliates2/cdem/for-students/online-education/m4-curriculum/group-m4-respiratory/pneumothorax.

Summarized by John Spartz, MS4 | Edited by Erik Verzemnieks, MD

The Emergency Medical Minute is excited to announce that we are now offering AMA PRA Category 1 credits™ via online course modules. To access these and for more information, visit our website at https://emergencymedicalminute.org/cme-courses/ and create an account.

Donate to EMM today!

Episoder(1146)

Podcast #249: Detecting Pulses

Podcast #249: Detecting Pulses

Author: Jared Scott, M.D. Educational Pearls Overall, medical providers are bad at detecting pulses. However, only 2% of patients do not have a detectable DP pulse. In one study, for patients with l...

10 Sep 20173min

Podcast #248: Family Presence During Resuscitation

Podcast #248: Family Presence During Resuscitation

Author: Aaron Lessen, M.D. Educational Pearls Traditionally the family is removed from the room during procedures and codes, but recent research shows that family presence may be beneficial. 50% pati...

8 Sep 20173min

Podcast #249: D-Dimer

Podcast #249: D-Dimer

Author: Michael Hunt, M.D. Educational Pearls In the recent YEARS study, investigators checked every patient with suspicion for PE with a D-dimer, using a modified Wells score for risk stratification...

6 Sep 20173min

Podcast #248: Patent Foramen Ovale

Podcast #248: Patent Foramen Ovale

Author: Jared Scott, M.D. Educational Pearls The foramen ovale (FO) connects the left and right atria to allow oxygenated blood to bypass the developing lungs, it usually closes at birth but for some...

4 Sep 20173min

Podcast #247: Are You Listening? - 3 Ear Emergencies You Can't Miss!

Podcast #247: Are You Listening? - 3 Ear Emergencies You Can't Miss!

Author: Don Stader, M.D. Educational Pearls Ear pain is a common complaint in adults and kids. A red, hot, painful ear with involvement of the pinna could indicate perichondritis - an infection of th...

2 Sep 20176min

Podcast #246: Fever in Sepsis

Podcast #246: Fever in Sepsis

Author: Nick Hatch, M.D. Educational Pearls A recent observational cohort study found that the biggest predictor for sepsis survival was fever. Those with higher fevers had better outcomes. Some poss...

31 Aug 20172min

Podcast #245: Hypoglycemia

Podcast #245: Hypoglycemia

Author: Dylan Luyten, M.D. Educational Pearls Hypoglycemia is very common in type 2 diabetics, and is often caused by insulin overdose or missed meals. Knowing the peak time of action for common diab...

29 Aug 20174min

Podcast #244: Clavicle Fracture Review

Podcast #244: Clavicle Fracture Review

Author: Nick Hatch, M.D. Educational Pearls The force required to break a clavicle is significant, so clavicle fracture may be associated with other injury (pneumothorax, vascular injury). Most fract...

27 Aug 20172min

Populært innen Vitenskap

fastlegen
rekommandert
tingenes-tilstand
jss
rss-rekommandert
liberal-halvtime
villmarksliv
sinnsyn
rss-paradigmepodden
forskningno
fjellsportpodden
nevropodden
rss-nysgjerrige-norge
vett-og-vitenskap-med-gaute-einevoll
diagnose
dekodet-2
smart-forklart
abid-nadia-skyld-og-skam
rss-lundqvist-podden
hva-er-greia-med