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Pneumothorax is a medical condition defined by the buildup of air in the pleural space between the lungs and the chest wall. This accumulation of air can lead to partial or complete lung collapse, resulting in a range of clinical manifestations. Understanding the clinical presentation and effective management strategies is crucial for healthcare professionals in providing timely and appropriate care to individuals with pneumothorax.
Clinical Manifestations:
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Diagnosing Pulmonary EmbolismDiagnosing pulmonary embolism (PE) involves clinical assessment and advanced imaging tests. The preferred diagnostic tool is the spiral (helical) CT scan or CT angiography (CTA), which uses intravenous contrast media to visualize the pulmonary vasculature and identify emboli.A ventilation-perfusion (V/Q) scan is an alternative for patients unable to receive contrast media. This scan includes both perfusion and ventilation scanning. Perfusion scanning involves...
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Managing flail chest, a condition characterized by a segment of the chest wall moving independently from the rest of the thoracic cage, requires a comprehensive approach. It includes a thorough assessment of the patient's condition, a diagnostic evaluation to determine the extent of the injury, and the implementation of appropriate medical interventions tailored to the individual's needs.
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To develop, implement and evaluate an integrated care pathway for patients presenting with pneumothorax.

Ben Shanahan1, Francis O'Keeffe2, Tomás Breslin2

  • 1Royal College of Surgeons in Ireland, 123 St Stephen's Green, Dublin 2, Ireland.

The Surgeon : Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
|March 24, 2022
PubMed
Summary

Implementing an integrated care pathway (ICP) for pneumothorax patients significantly reduced hospital stays and costs. This standardized approach to ambulatory care for pneumothorax offers economic benefits to healthcare systems.

Keywords:
Ambulatory careCare pathwayChest drainEconomic evaluationEmergency medicinePneumothoraxThoracic surgery

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Area of Science:

  • Healthcare Management
  • Thoracic Surgery
  • Health Economics

Background:

  • Pneumothorax management varies across Irish healthcare centers.
  • Ambulatory care for pneumothorax is proven feasible and safe.
  • Need for standardized care pathways in acute settings.

Purpose of the Study:

  • Evaluate the economic benefits of an integrated care pathway (ICP) for pneumothorax.
  • Focus on implementing ambulatory care for suitable pneumothorax patients.
  • Assess the impact of ICP on healthcare system costs in Ireland.

Main Methods:

  • Developed and implemented a novel ICP for pneumothorax patients.
  • Conducted a prospective, multi-center observational study in Ireland.
  • Performed a rigorous economic analysis alongside clinical evaluation.

Main Results:

  • ICP implementation reduced inpatient length of stay by 2.84 days (p=0.001).
  • Achieved an average cost reduction of €2314 per patient.
  • No adverse events related to drain insertion were reported.

Conclusions:

  • Standardized pneumothorax care via ICP with ambulatory focus is economically beneficial.
  • ICP implementation supports cost-effective public healthcare.
  • Findings can inform national healthcare policy for pneumothorax management in Ireland.