CXR Flashcards
mx of perorated bowel
this is finding on cxr pneumopertioenum
A-E assessment
urgent referral to surgeons
IV PPI, IV abx and IV analgesia
how do you treat pleural effusion
A-E
aspirate and drain the fluid via pleural thoracocentesis - potentially under the guidance of ultrasound if needed
test for protein, culture and LDH level
compare values to that of serum level
helps decide whether exudate or transudate
diuretic such as IV foursemide 40mcg stat if cogenstive heart failure
IV abx if infection
pulmonary oedema managemetn - HF
A-E assessment and take blood - FBC, UandE
sit up and deliver oxygen
IV furosemide 40mcg STAT
ECHO for HF
mass so cancer
A-E
bloods and bone profile
spirometry
staging CT thorax abdo
refer to resp and oncology
treatment dependent on finding from all of the above
pancost tumour
A_E
urgent CT and biopsy
platinum based chemo and surgery
pneumonia
A-E
bedside sputum and bloods - FBC, CRP, U&E AND procalcitonin
oxygen if needed
give abx according to local and trust guidlines - amoxicllin or doxy
callcualte CURB 65 score too which could help guid further
3-4 coamox, clarithro, ICU
2- hosp with abx
rib fracture mx
A-E
pain relief
chest physio and breahing exercises
oxygen if needed
repeat CXR to be considered
be aware of complications = pnemothorax
tx of underlyign cause fo example osteoporsis wit bisphophophonates and caclium supplements
pulmonary fibrosis - shadow lung peripheries
A-e
CT to confirm
pulmonary rehab and physio
smoking cessation
refer to resp for further management for pirfernidone
high dose corticosteriod if acute exacerbation
hilar lymphadenopathy
A-e
mantoux test adn sputum sample
blood - FBC and bone profile( hypercalcaimia), LFTs and serum ACE
NSAID
indication for steriods if eye involvement heart or neuro involvement
CT more detail
pneumothorax
a-e
if under 2cm no SOB discharge and follow up in 2w -4w - observe and oxygen
over 2cm - aspirate twice then chest drain
pain relief
dotn smoke , dotn fly for one week , avoid diving
lobar collapse
Possible lobar collapse management plan:
Deep Breathing Exercises/ Physio
Pain Management
