Friday, March 12, 2010

Overzealous

This patient came in with a GCS of 7. His chest X ray on arrival was normal. The emergency room physicians fussed around with him a bit, and now he looks like this.

Challenge: What's the cause?

Image is shown under Fair Use.

3 comments:

tree said...

The silly ED physicians inserted the ET tube too far without listening for breath sounds on both sides. Next time call an anesthesiologist!

Suheil said...

Left Lung and Right Apical collapse due to insertion of the E.T. Tube past the carina and into the right main bronchus ??

Craig Chen said...

exactly right! nice job
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Overzealous

This is a right mainstem intubation. The tip of the endotracheal tube projects below the carina into the right bronchus intermedius. Thus, only the patient's right lung is being ventilated; the left lung and RUL are atelectatic.

Source: LearningRadiology.