Tension Pneumothorax or Decreased Level of Consciousness

berry · Feb 15, 2004

If two patients present to the emergency department at the same time, one with a tension pneumothorax and the other with decreased LOC, which one should receive attention first? Thanks.

I would pick the pneumothorax if the other is just a decreased loc, my reason Trauma assessment Airway, Breathing, Circulation, Disablity(neuro Checks, oreintation) but "decreased LOC is such a broad complaint are they unresponsives possabilty of losing ariway then i take them over the pneumo or have the just been "acting different for a few days". is this a real world scene or a textbook question

veetach · Feb 15, 2004

The patient with the pneumothorax. Always follow your ABC rule, AIRWAY comes first.

RNin92 · Feb 15, 2004

The patient with the pneumothorax. Always follow your ABC rule, AIRWAY comes first.

I'm with veetach...

AIRWAY-AIRWAY-AIRWAY

trsnurse · Feb 18, 2004

I'm with veetach...
AIRWAY-AIRWAY-AIRWAY

ditto AIRWAY!

gij1 · Feb 18, 2004

I would definately pick pnuemothorax, although decreased LOC is alarming. Good ole ABC's. Did you get this on a test??? Let us know.

petiteflower · Feb 19, 2004

I'm with everyone else, tension pneumo

kc ccurn · Feb 19, 2004

I'm with everyone else, tension pneumo

My answer as well.

Speculating · Feb 19, 2004

If two patients present to the emergency department at the same time, one with a tension pneumothorax and the other with decreased LOC, which one should receive attention first? Thanks.

As long as the pneumo was your typical young skinny white guy and it was spontanous not traumatic and he was running a good SAT I would crank the O2 up and work on the

RNin92 · Feb 19, 2004

As long as the pneumo was your typical young skinny white guy and it was spontanous not traumatic and he was running a good SAT I would crank the O2 up and work on the
You read too much into the question. The poster said TENSION pneumo not spontaneous. You have far less time to a dead pt with a tension than a CVA.
AIRWAY first.

Speculating · Feb 19, 2004

You read too much into the question. The poster said TENSION pneumo not spontaneous. You have far less time to a dead pt with a tension than a CVA.
AIRWAY first.

Any situation that results in inducing a pneumothorax can begin the foundation of a tension pneumothorax. A tension pneumothorax is simply a complicated pneumothorax. Can a spontaneous pneumothorax be a tension pneumothorax - ABSOLUTELY! I'm simply trying to find out the root of the pneumothorax. Again that's why I asked if there was any trauma involved. I addressed the airway with cranking up the O2 and keeping a very close eye on the pts SAT. Now I'm going to address the airway in the

RNin92 · Feb 19, 2004

As long as the pneumo was your typical young skinny white guy and it was spontanous not traumatic and he was running a good SAT I would crank the O2 up and work on the
YOU stated about a small window of opportunity of TPA for a stroke. I never said anything about thinking a decreased being a stroke. I just was responding to YOUR words.
As far as O2 sats go...they are a screening tool...not a blood gas. They are a piece of the puzzle not the answer. And you can "crank the O2 up" from now until the end of time and it will not help your AIRWAY problem in a tension pneumo.
And all I said was...I thought you were reading too much into the question. Not challenging your choices. But in a multi-victim situation if I ONLY know that one pt is a tension pneumo and the other has a decreased LOC I will pick AIRWAY first every time. I would not FORGET the decreased LOC but he will wiat for the 2 minutes it will take for me to needle the tension and save his life.