While at work one evening in the ER a gentleman was placed in my room with the diagnosis of SOB. I went in to do my RN assessment and while taking his history he disclosed that he had been running a fever with SOB for the past 3 weeks and became increasing SOB this evening. My assessment reveled a fever of 104.2 orally, and diminished breath sounds in the lobes of the left lung. I went ahead and started the pneumonia protocol, started his IV drew blood and blood cultures, ordered and Xray and started IV antibiotics.
The physician walked up to me and said," I dont think this man has pneumonia I think his lung is collapsed". I gathered my supplies to assist with chest tube insertion. The patient was sediated and the physician started the procedure.
At the point when he opened the pleural cavity an immediate gush of pus came running out of the patients chest, we placed the chest tube to suction via pleural -vac and immediately returned 2100 cc of pus into the collection chamber!!!!!
Needless to say that after the patient awoke from sediation he was feeling much better, except for the large chest tube we had just placed.
So even though he didn't have pneumonia, as I thought he was still in great need of IV antibiotics.
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