The Resus Room November 2024; papers of the month
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Nov 1, 2024 Dive into the latest research on post-resuscitation pneumothorax, revealing that around 11% of patients may be affected after CPR. Explore the complexities of diagnosing vertigo with a new clinical risk score that aims to improve patient assessment in the emergency department. Lastly, the discussion tackles the challenges of pre-alerts and the need for better communication between emergency services and departments, highlighting the importance of streamlined processes for optimal patient care.
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Pneumothorax Is Not Rare After CPR
- Post-ROSC pneumothorax occurred in about 11% of hospitalized non-traumatic cardiac arrest patients in this cohort.
- History of COPD raised pneumothorax odds and many cases required chest drains.
Detection Depends On Imaging And Clinician Judgment
- Imaging modality influenced detection with CT and ultrasound finding more pneumothoraces than chest x-ray.
- Timing and clinician gestalt likely affected which patients received advanced imaging and thus detection rates.
Lower Your Threshold For Post-ROSC Chest Imaging
- Respect CPR as a traumatic event and maintain a low threshold for chest imaging after ROSC.
- Consider patient history (e.g., COPD) when deciding on post-arrest imaging.