Your Choice Draft 1- Thomas Ko
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Dec 6, 2023
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Uploaded by ChancellorFangManatee29
After Visit Summary: Pneumothorax
Patient Name: Thomas Ko 2/27/2002
Hi Thomas, it was a pleasure taking care of you in the hospital!
You were admitted for Primary
Spontaneous Pneumothorax (PSP).
After observing you on oxygen for two days, we believe you
are ready for discharge now.
Below are specific instructions for the future and further details
about PSP.
1.
Schedule an appointment with a pulmonologist to monitor your recovery
2.
Do not smoke cigarettes or vape as it increases the risk of PSP (Wong et al., 2018).
A
new study also found that the combination of tobacco and cannabis has a cumulative
toxic effect that increases the risk of PSP (Underner et al., 2018).
3.
Avoid air travel, scuba diving, and physical contact sports until the pulmonologist clears
you (Wong et al., 2018).
Important Vital Changes:
Respiration: 22 at admission, 18 at discharge
Pulse Oximetry: 93% at admission, 100% at discharge
Notes:
Respiration rate is measured by the number of breaths you can take in a minute (Johns Hopkins
Medicine).
Higher respiratory rate is a common symptom of PSP (McKnight and Burns, 2023).
Pulse oximetry measures the oxygen saturation of your blood (Johns Hopkins Medicine).
Your
saturation levels returned to normal (>94%) after administering oxygen (Wong et al., 2018).
Pneumothorax
Pneumothorax, commonly called a collapsed lung, occurs when there is an excessive amount of
air in the pleural space of the lungs (McKnight and Burns, 2023).
The accumulated air results in
pressure against the lung that makes it collapse (McKnight and Burns, 2023).
PSP is usually
diagnosed through an x-ray (McKnight and Burns, 2023).
Below is an image to help visualize the
difference between a healthy and collapsed lung:
https://www.netmeds.com/health-library/post/pneumothorax-causes-symptoms-and-treatment
Symptoms of PSP include difficulty breathing, chest pain, and diminished breath sounds (Wong
et al., 2018).
You had a primary spontaneous pneumothorax, which can happen in young,
healthy adults with no underlying health conditions; it occurs in around 22 per 100,000
individuals (Wong et al., 2018).
It typically affects tall, thin men between the age of 10 and 30
years (Wong et al., 2018).
There are a couple of factors that increase the likelihood of PSP,
including smoking and family history (Wong et al., 2018).
Additionally, PSP has a high tendency
to recur within the first year, with around 25% to 50% (McKnight and Burns, 2023).
Treatments
The treatments of PSP depend on the severity of the condition (McKnight and Burns, 2023).
Since you presented a small depth (less than 2 cm), supplemental oxygen with observation was
sufficient (McKnight and Burns, 2023).
However, for more severe cases, a needle aspiration may
be necessary; this involves a needle being inserted into the pleural space, which will manually
withdraw air (McKnight and Burns, 2023).
For patients who have recurring PSP, usually a chest
tube is inserted; the tube is able to connect to a water seal device to engage suction to resolve
the pneumothorax (McKnight and Burns, 2023).
This form of interventional drainage is often painful, so researchers compared conservative and
interventional treatment for PSP (Brown et al., 2020).
It was found that conservative
management resulted in a lower risk of pneumothorax recurrence (Brown et al., 2020).
The
treatment is usually decided by the practitioner; however, we do not expect you to experience a
recurring PSP due to your small case (Wong et al., 2018).
In the meantime, if you experience
any of these following symptoms again: respiratory discomfort, absent breath sounds, or
increased respiratory rate, seek medical help immediately (McKnight and Burns, 2023).
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Brown, Simon G.A., et al. “Conservative versus Interventional Treatment for Spontaneous
Pneumothorax.”
New England Journal of Medicine
, vol. 382, no. 5, 30 Jan. 2020, pp.
405–415,
https://doi.org/10.1056/nejmoa1910775
. Accessed 30 Apr. 2020.
Johns Hopkins Medicine. “Health Home.”
JOHNS HOPKINS MEDICINE
, 2019,
www.hopkinsmedicine.org/health
.
McKnight, Catherine L., and Bracken Burns. “Pneumothorax.”
PubMed
, StatPearls Publishing,
2021,
www.ncbi.nlm.nih.gov/books/NBK441885/#:~:text=A%20pneumothorax%20is
%20a%20collection
.
Underner, M., et al. “[Spontaneous Pneumothorax and Lung Emphysema in Cannabis Users].”
Revue de Pneumologie Clinique
, vol. 74, no. 6, 1 Dec. 2018, pp. 400–415,
pubmed.ncbi.nlm.nih.gov/30420278/,
https://doi.org/10.1016/j.pneumo.2018.06.003
.
Accessed 13 Nov. 2023.
Wong, Amy, et al. “Management of Primary Spontaneous Pneumothorax: A Review.”
ANZ
Journal of Surgery
, vol. 89, no. 4, 5 July 2018, pp. 303–308,
https://doi.org/10.1111/ans.14713
.