Rosh Review EM Scholar Monthly Question

You are working in a rural ED, and an older woman from a local assisted care facility arrives via ambulance in obvious respiratory distress. EMS is able to tell you that she is currently being treated for pneumonia. The patient is on a nonrebreather mask, and vital signs on arrival are BP 110/50 mm Hg, HR 120 bpm, RR 40/min, T 98.6°F (37°C), and SpO2 86%. The patient’s emergent portable chest X-ray is shown below. Which of the following is the most appropriate next step in this patient’s care?

1. Frantically look through the assisted care documents for do-not-resuscitate paperwork
2. Place a chest tube on the left side
3. Place a chest tube on the right side
4. Start noninvasive or mechanical ventilation

FOR THE RIGHT ANSWER CLICK ON THE ROSH REVIEW LOGO BELOW

References:

1. Dixon A. Mucous plug with left lung collapse. Radiopaedia website. Accessed October 19, 2022.
2. Friesen B. Left upper lobe collapse due to mucous plugging. Radiopaedia website. Accessed October 19, 2022.

Post Peer Reviewed By: Salim R. Rezaie, MD (Twitter: @srrezaie)