[Solved]: Skip to main content Question LOCATION: Inpatient,…

Skip to main content Question LOCATION: Inpatient, Hospital PATIENT: Colin Brandle SURGEON: Gregory Dawson, M.D. PROCEDURE PERFORMED: Chest tube placement. PREOPERATIVE DIAGNOSIS: Symptomatic pneumothorax development after placement of a permanent pacemaker. POSTOPERATIVE DIAGNOSIS: Same. INDICATIONS: Symptomatic pneumothorax development after placement of a permanent pacemaker. DESCRIPTION OF PROCEDURE: With the usual Betadine scrub to the left lateral chest and with 25 cc of local lidocaine used for total anesthesia a sharp incision was made through the skin and subcutaneous tissue with a #11 blade and blunt dissection with a curved tip hemostat was done from the subcutaneous tissue down to the pleural space. Once the pleural space was entered an immediate bubbling of air was noted and relief of pressure and once that was accomplished we had a site big enough to put a chest tube in and a #28 chest tube was pushed into position, hopefully anterior and superior as we tried to direct it, however, the patient was having some discomfort at this point and it was difficult to direct it. When the last part of the chest tube was in the pleural space the patient did have a little bit of neck pain, hopefully with time that will ease off and hopefully the lung will re-expand and we can just make this one to two days rather than the usual three to four. Once the chest tube was in place the chest tube was sewn into position and Roman laces from that particular stitch were tied on the chest tube itself and the rest of them were interrupted to close the wound. A dressing was applied. Chest x-ray will be taken afterwards to assure ourselves we have accomplished our goal and we will get daily chest x-rays until the chest tube is out. idc10cm idc10pcs