Chest
Selected ReportsSimple Construction of a Subcutaneous Catheter for Treatment of Severe Subcutaneous Emphysema
Section snippets
Case Report
A 50-year-old man presented to his family doctor with an exacerbation of COPD. He was initially treated with albuterol and oral steroid therapy (40 mg po once daily, then tapering). The patient's medical history was noncontributory, except for a 50 pack-year smoking history, and he had lost approximately 20 lb over the previous 2 to 3 months. Within a few days, fevers, chills, rigors, and a dry cough developed. He was admitted to the hospital in respiratory distress. His chest radiograph at
Discussion
The catheters are easily constructed. The fenestrations are readily created by leaving the angiocatheter over the steel stylette and using a scalpel blade to create the holes. To enhance the rigidity of the catheter, the fenestrations are created in a spiral pattern. A povidone-iodine swab is used to prepare the skin and, if desired, a small amount of local anesthetic can be used. The site of insertion is 2 to 3 cm lateral to the midclavicular line over the third rib. The catheter is inserted
ACKNOWLEDGMENT
The authors thank Dr. Stephen K. Field, MD, FCCP, for his careful review of the manuscript.
References (18)
- et al.
Systematic approach to pneumothorax, hemothorax, pneumomediastinum and subcutaneous emphysema
Injury
(1986) - et al.
Massive spontaneous subcutaneous emphysema: acute management with infraclavicular “blow holes.”
Chest
(1992) - et al.
Palliation of severe subcutaneous emphysema with use of a trocar-type chest tube as a subcutaneous drain [letter]
Chest
(1993) Pneumomediastinum as a cause of dysphagia and pseudodysphagia
Ann Emerg Med
(1981)- et al.
Pneumatic chest wall compression: a cause of respiratory failure from massive subcutaneous emphysema
Chest
(1991) - et al.
Acute ventilatory failure from massive subcutaneous emphysema
Chest
(1993) - et al.
Pacemaker malfunction due to subcutaneous emphysema
Int J Cardiol
(1990) - et al.
Subcutaneous emphysema producing airway compromise after anesthesia for reduction of a mandibular fracture: a case report and review of the literature
Oral Surg Oral Med Oral Pathol Oral Radiol Endod
(1991) Transport of air along sheaths of pulmonic blood vessels from alveoli to mediastinum: clinical implications
Arch Intern Med
(1939)
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Dr. Beck is a Clinical Investigator of the Alberta Heritage Foundation for Medical Research, and Dr. Mody is a Scholar of the Alberta Heritage Foundation for Medical Research.