Efast in the Emergency Room for the Diagnosis of Pneumothorax: Report of a Case

Abstract

Free air in the pleural space may occur spontaneously or may be acquired. It is a frequent condition in first-aid clinics. People with thorax trauma may develop pneumothorax and risky complications. The use of Extended Focused Assessment with Sonography for Trauma (EFAST) triggers progress in the diagnosis of such life-endangering lesions. Current report shows an early diagnosis of pneumothorax with the use of EFAST in a patient suffering from close thorax trauma. The 65-year-old male patient was admitted to the emergency room of a University Hospital after a two-day-old car crash. He complained of ventilator-dependent thorax pain especially on the left side and dyspnea with great efforts. Vesicular murmur was present at the right hemithorax but abolished at the third lower part of the left hemithorax. EFAST revealed left pneumothorax and a thoracostomy with left pleural drainage was performed without any inter-occurrences and the pneumothorax was solved. He quitted hospital after 4 days with a satisfactory clinical condition and adequate lung re-expandability. Ultrasonography of the thorax in trauma victims is not invasive, portable and easily executed. In fact, it proved to be better than X-ray of the thorax in terms of sensitiveness, and even better than computer tomography regarding time and d exposure of the patient to radiation. Its use should be expanded and applied as a primary assessment of all polytraumatized patients attended at the emergency room.