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Tension pneumothorax secondary to automatic mechanical compression decompression device.
A C Hutchings1, K J Darcy, G L A Cumberbatch
1Royal Bournemouth Hospital, Bournemouth, UK.
Emergency Medicine Journal : EMJ
|January 24, 2009
Summary
This case report details a tension pneumothorax caused by an automatic compression-decompression (ACD) device during cardiac arrest. Unilateral absent breath sounds in intubated patients using ACD devices warrant consideration of pneumothorax.
Area of Science:
- Emergency Medicine
- Cardiology
- Pulmonology
Background:
- Cardiac arrest management often involves advanced airway techniques and mechanical chest compression devices.
- Automatic compression-decompression (ACD) devices are utilized to provide continuous cardiopulmonary resuscitation during cardiac arrest.
Observation:
- A case of tension pneumothorax is described, which was induced by an ACD device in an elderly patient experiencing pulseless electrical activity (PEA) arrest.
- The patient presented with unilateral absent breath sounds after intubation and application of the ACD device, despite confirmed endotracheal tube placement.
Findings:
- Post-mortem examination revealed the cause of death was a ruptured abdominal aortic aneurysm.
- The ACD device use was associated with multiple left rib fractures and a left lung laceration, leading to a tension pneumothorax.
- The tension pneumothorax was not deemed to have contributed to the patient's death by the pathologist.
Implications:
- Clinicians should consider pneumothorax (simple or tension) in patients with unilateral absent breath sounds during endobronchial intubation when an ACD device is in use.
- This case highlights a potential complication of ACD devices that requires prompt recognition and management.
- Further investigation into the incidence and prevention of ACD-induced barotrauma is warranted.
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