Does he need a drain?
This is the CXR if an elderly gentleman, 83 years, who presented in resus after a collapse.
He was found to be SOB and had a CXR:
What do you think: does he need a drain?
On further inspection and manipulating the x-ray:
The clinician looking after the patient was not clinically convinced that there was a pneumothorax, so had a discussion with the radiology team. They decided to repeat the x-ray:
The pneumothorax has moved!
The outcome was that this was shadowing from a skin fold. A further clue is the shadow extends beyond the lung fields, and there are lung markings visible peripheral to the line which may indicate a pneumothorax. NO PNEUMOTHORAX.
N Bothma on behalf of J Smith
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