Pediatric emergency medicine trisk 3701 3701

FIGURE 115.3 A 5-year-old girl fell off and was then kicked in the chest by a horse. Upon
arrival of the life-flight team, the patient was found to be in both respiratory and cardiovascular
distress. Chest radiograph demonstrated a left-sided tension pneumothorax. The patient was
intubated, and a chest tube was placed before the patient was transported. After the intubation
and chest tube insertion, both the patient’s respiratory and cardiovascular status improved.

Reported sensitivity of the E-FAST examination in children is lower than that
noted in adults. In addition, children are less likely to undergo operative repair
even when free fluid in the abdomen is identified, therefore the role for FAST
testing is different in children than adults. Nonetheless, with thoracic trauma,
identification of air or blood in the pleural space on avoid confusion may rapidly
influence the decision for tube thoracostomy in children with respiratory or
hemodynamic compromise.

Management
Needle Decompression