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Tension pneumothorax and diffuse subcutaneous emphysema as a complication of cardiopulmonary resuscitation
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  1. Ahmad Sharayah1,
  2. Dileep Unnikrishnan1,
  3. Prem Shanker Shukla1,
  4. Douglas Livornese2
  1. 1Internal Medicine, Monmouth Medical Center, Long Branch, New Jersey, USA
  2. 2Pulmonary and Critical Care, Monmouth Medical Center, Long Branch, NJ, Monmouth
  1. Correspondence to Dr Ahmad Sharayah, drsharayah{at}gmail.com

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A 65-year-old man, with a medical history of interstitial lung disease and a recently diagnosed lung adenocarcinoma with known metastases to the bone, was brought to the emergency department after an episode of cardiopulmonary arrest and resuscitation by emergency medical services (EMS). The patient had a recent hospitalisation for bronchoscopic lung biopsy. It was complicated by a pneumothorax, and he was treated with chest tube insertion. The tube was removed 2 weeks prior to the current encounter and no residual leak was found. On the day of arrival, early morning, the patient’s wife found him unresponsive with a temperature of 101 degrees Fahrenheit (38.3 Celsius). EMS was called and the patient was found in pulseless electrical activity. Advanced cardiac life support was initiated and he had a return of spontaneous circulation after two doses of 1 mg epinephrine over approximately 6 min of cardiopulmonary resuscitation (CPR). The patient was intubated in the field and brought to the emergency department. …

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