Season 3 Case 8

chest Sep 15, 2014

Case 8

History: tube/line placement



Finding wasn’t too difficult right? But the history was the hint

We have a widened upper mediastinum, which extends into the base of the neck. Did you think of aortic rupture/injury? it is a good thought. Any pleural fluid? Where is the “mass” centered?

Answer: Large neck hematoma post ATTEMPTED line placement. No prior that I can remember. Regardless, although the patient is intubated, you probably should pick a phone and talk with the doc about this one.

Unfortunately histories can be misleading and incorrect a lot of the time, but always keep them in mind. If you see “line placement” and no line, it is probably a wise idea to consider it a “line attempt” and consider consequences of such



Professor of the Darkroom Arts

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