The FEC phenomenon — who decides what is an emergency?

✍ Scribed by R Leidelmeyer

• Book ID: 104312928
• Publisher: Elsevier Science
• Year: 1984
• Tongue: English
• Weight: 344 KB
• Volume: 13
• Category: Article
• ISSN: 1097-6760
• DOI: 10.1016/s0196-0644(84)80503-x

✦ Synopsis

CORRESPONDENCE

relieve the urgency of the situation as well as the sphincter tone of the examiner. Needle thoracostomy should be followed by tube thoracostomy to prevent recurrence of the tension pneumothorax. Most studies report about 20% to ..30% recurrence of spontaneous pneumothorax.l,3,s,6 The chance of recurrence increases with each episode. Recurrent pneumothorax may require surgical intervention with pleurectomy, pleurodesis, or excision of the involved pulmonary parenchyma.Z,n, 2o

Death from pneumothorax is rare. A fatal outcome is generally associated with a serious underlying pathologic process such as tuberculosis or tumor. Death in uncomplicated cases is only 0.9%. 21 Saltet,22 using a manometer needle before opening the chest, reported 26 cases of unsuspected tension pneumothorax in a series of 685 adult necropsies. The implication is that sudden death from tension pneumothorax may far exceed reported estimates. Tragically the solution is so simple, but often delayed or missed because of a low index of suspicion.