Edgar arrived to the Emergency room after a truck backed up and pinned him between the truck and a wall. He had severe chest pain, a thready pulse and oxygen saturation that was dropping rapidly. On exam he was noted to have no breath sounds on the right side of his chest and you could feel the air bubbling under his skin. He was diagnosed with a pneumothorax and feared to be developing a tension pneumothorax.
This is occurs when the lung is punctured (in Edgar's case by one of his many broken ribs.) Air, from the lung, enters the thoracic cavity and compresses the lung. The increasing pressure causes the lung to collapse and if the pressure is not relieved can cause collapse of the venous return to the heart and death.
The ER crew acted rapidly and placed IVs, started oxygen and prepared for a tube thoracostomy. This tube, placed into the chest wall, helps to relieve the pressure that is increasing in the patients chest.
The tube was placed without difficulty and immediately Edgar was breathing easier and his oxygen saturations increased. Edgar then was transported to Guatemala City where he spent 8 days in the hospital and ended up having part of his damaged lung removed.
On follow up he was all smiles and very thankful for the care he received.