Mastodawn

Random: Collapsed lung? Two weeks to recover?!? That's a major, critical injury (I surmise, flail chest --where you break your ribs in multiple places, leading to a collapsed lung and inability to breathe).

AP: "Pistons guard Cade Cunningham has collapsed lung, will miss time, AP source says"

https://apnews.com/article/pistons-cade-cunningham-hurt-b3902c010af974a3a9f0693fc33f52a7?utm_source=flipboard&utm_medium=activitypub

Pistons' Cade Cunningham has collapsed lung, will miss at least 2 weeks

All-Star guard Cade Cunningham of the Eastern Conference-leading Detroit Pistons has a collapsed lung and is expected to miss at least two weeks and possibly more. The team announced the diagnosis Thursday. The Pistons listed Cunningham as out for Thursday’s game in Washington with a left back contusion. Cunningham got hurt in Tuesday’s win over Washington, leaving midway through the opening quarter with what the team called back spasms. Cunningham is averaging 24.5 points and 9.9 assists for the Pistons. Detroit entered Thursday 3 1/2 games ahead of Boston for the top spot in the East with 14 games remaining.

AP News

AI6YR Ben Mar 19

That is an "evacuate immediately" and nothing you can do in the field injury, if I am reading that right. #firstaid

MsMerope Mar 19

@ai6yr
Yeah, pretty much you try to stabilize it as much as you possibly can but you’re looking at Potential pneumothorax, and Lord knows what else depending on where that break is, and what other organs or vascular structures it’s gonna puncture

AI6YR Ben Mar 19

@MsMerope Yeah, that's not two weeks and back on the court

FreddyB Aviation Photography Mar 19

@MsMerope @ai6yr Yep splint that sucker and have a needle handy for decompression small sand bags are good for this at least on the lateral aspect

MsMerope Mar 19

@cvvhrn @ai6yr
Needle decompression is a little bit out of my scope of practice

Though there are some people that I would like to jab with a needle or a machete 🤷🏻‍♀️

FreddyB Aviation Photography Mar 19

@MsMerope @ai6yr lol

AI6YR Ben Mar 19

@cvvhrn @MsMerope Yeah, decompression out of scope of WFA training. (used to be in there, but they removed it... probably figured people would screw it up and/or there were bad outcomes).

Jim Hubbell Mar 19

@ai6yr @cvvhrn @MsMerope
You might argue anyone with a collapsed lung in the wilderness is already suffering a bad outcome.

Jim Hubbell Mar 20

@ai6yr @cvvhrn @MsMerope
I've learned today there is more than one way to cause a collapsed 🫁.

FreddyB Aviation Photography Mar 20

@Dougfir @ai6yr @MsMerope Oh man let me count the ways lol

FreddyB Aviation Photography Mar 19

@ai6yr @MsMerope Second intercostal space mid clavicular line and go over the top of the rib to avoid the nerve bundle

@stevewfolds Mar 19

@ai6yr
Ow. Hope that he can play in two weeks.

Jim Hubbell Mar 19

@ai6yr
My wife had flail chest and a punctured lung in the car accident. It was quite impressive to this emt trainee. One of the ER docs tried to reinflate it while she was on the gurney just before we took a quick ride down to UC Davis med center.

AI6YR Ben Mar 19

@ai6yr I've had a collapsed lung and a cracked rib! Collapsed enough that I couldn't breathe for a bit, but got it going myself. A final jagged inhale. It happened when I got a bit airborne and then came down to take a water ski across the chest.

No, I don't remember that I would have wanted to play sports 2 weeks later. I think I tried mountain biking maybe 3 weeks later and that was a bit painful.

AI6YR Ben Mar 19

@buckfiftyseven Ouch

@ai6yr I think everybody wears a full vest now water skiing or similar, but definitely wear a full vest. Thick too.

(I was wearing a full vest.)

Wendroid 🇺🇦Mar 19

@ai6yr I had a pneumothorax. Deeply unpleasant. Two weeks plus.

@wendinoakland @ai6yr

did you need a chest drain?

https://publications.ersnet.org/content/erj/63/5/2300797

Joint ERS/EACTS/ESTS clinical practice guidelines on adults with spontaneous pneumothorax

BackgroundThe optimal management for spontaneous pneumothorax (SP) remains contentious, with various proposed approaches. This joint clinical practice guideline from the ERS, EACTS and ESTS societies provides evidence-based recommendations for the management of SP.MethodsThis multidisciplinary Task Force addressed 12 key clinical questions on the management of pneumothorax, using ERS methodology for guideline development. Systematic searches were performed in MEDLINE and Embase. Evidence was synthesised by conducting meta-analyses, if possible, or narratively. Certainty of evidence was rated with GRADE (Grading of Recommendations, Assessment, Development and Evaluations). The Evidence to Decision framework was used to decide on the direction and strength of the recommendations.ResultsThe panel makes a conditional recommendation for conservative care of minimally symptomatic patients with primary spontaneous pneumothorax (PSP) who are clinically stable. We make a strong recommendation for needle aspiration over chest tube drain for initial PSP treatment. We make a conditional recommendation for ambulatory management for initial PSP treatment. We make a conditional recommendation for early surgical intervention for the initial treatment of PSP in patients who prioritise recurrence prevention. The panel makes a conditional recommendation for autologous blood patch in secondary SP patients with persistent air leak (PAL). The panel could not make recommendations for other interventions, including bronchial valves, suction, pleurodesis in addition to surgical resection or type of surgical pleurodesis.ConclusionsWith this international guideline, the ERS, EACTS and ESTS societies provide clinical practice recommendations for SP management. We highlight evidence gaps for the management of PAL and recurrence prevention, with research recommendations made.

European Respiratory Journal

Wendroid 🇺🇦Mar 20

@amiserabilist @ai6yr Here I am in hospital getting all the requisite tubes and fittings. Not slightly comfortable. (2023)

scary.

Wendroid 🇺🇦Mar 20

@amiserabilist …but wait, there’s more!

for a day, while . . . 🗽Mar 20

@wendinoakland @amiserabilist @ai6yr

so sorry about your lung, hope it's re-inflated very soon . . .

glad to see your fiery finger . . .

it was 3 years ago and took 2 weeks to heal.

for a day, while . . . 🗽Mar 20

. . . and having a chest tube really sucks . . .

Wendroid 🇺🇦Mar 20

@cgsines @amiserabilist @ai6yr Old injury, glad it’s history!

Wendroid 🇺🇦Mar 20

@amiserabilist @ai6yr This invasive entity lived with me for the entirety of my healing, a 10+ cm tube which passed deep into my chest, which was removed when the wound was determined to have healed, about two weeks from the beginning.

and wondering around with your bottle.

what a relief to get it out.

Wendroid 🇺🇦Mar 20

@amiserabilist There was a big flat sticky thing on my chest from which the tube extended inward. That rolled up bit is the old adhesive surface, plus some mysterious bits & bobs. Grisly stuff.

ʙᴇɴ ᴄᴏᴛᴛᴇяɪʟʟ Mar 20

@wendinoakland @amiserabilist I like in medical terms. The surgeon didn’t leave stuff in there. The patient’s body took it.

Wendroid 🇺🇦Mar 20

@BenCotterill @amiserabilist Glad to give that back. I literally had fainted on the steps in my backyard, spun around and fell on my back onto a sharp retaining wall corner. Dangers in & around the home.

broken rib?

ʙᴇɴ ᴄᴏᴛᴛᴇяɪʟʟ Mar 20

@wendinoakland @amiserabilist Remember in the report. Its YOUR fault for taking it with you.

Wendroid 🇺🇦Mar 20

@BenCotterill @amiserabilist Wait, wut? I gladly gave it back!

ʙᴇɴ ᴄᴏᴛᴛᴇяɪʟʟ Mar 20

@wendinoakland @amiserabilist read later reports. NEVER their fault.

i think it is requested from the insurance company.

the hospital has a fund they pay out from.

NHS Crown indemnity (now mostly state-backed schemes) provides clinical negligence cover for NHS employees and contracted GPs in England and Wales for NHS work, ensuring they are protected if a patient makes a claim. It covers negligence occurring on or after 1 April 2019 for GP services (CNSGP).

but they pay a defense union too.

https://www.bma.org.uk/advice-and-support/medical-indemnity/medical-indemnity/nhs-medical-indemnity

Avoidable mistakes in the NHS cost roughly £2.5 billion to over £14 billion annually, with clinical negligence payments exceeding £2.8 billion in 2023–24. These costs stem from avoidable safety incidents, such as medical errors, maternity issues, and medication mistakes, which impact patient care.

https://www.theguardian.com/society/2024/dec/12/nhs-spends-147bn-a-year-treating-patients-in-england-hurt-by-care-mistakes-says-report

there are no new mistakes, just the same old ones.

Medical errors are estimated to be the third leading cause of death in the United States, following heart disease and cancer. Research suggests that over 250,000 deaths annually occur due to medical errors in U.S. hospitals. These errors include misdiagnosis, surgical mistakes, medication errors, and system failures.

https://www.npr.org/sections/health-shots/2016/05/03/476636183/death-certificates-undercount-toll-of-medical-errors

NHS medical indemnity

Read an overview of NHS medical indemnity systems in the UK.

The British Medical Association is the trade union and professional body for doctors in the UK.

hi @BenCotterill

it is a chest drain and is meant to stay in till the lung has inflated and healed.

in @wendinoakland's case, 2 weeks.

it was not medical error.

https://en.wikipedia.org/wiki/Chest_drainage

Chest drainage - Wikipedia

ʙᴇɴ ᴄᴏᴛᴛᴇяɪʟʟ Mar 20

@amiserabilist @wendinoakland my bad.

Wendroid 🇺🇦Mar 20

@amiserabilist @ai6yr TL:DR.

We would have active young men come into ED with collapsed lung from low impact trauma or impact in sport. For some reason it seems the lung detaches itself from the chest wall (something to do with the surfactant) We even had one young man who had his car stereo up so loud, the bass rattled the lung off the chest. Decompress with a rocket valve and no actively for a couple of months. 2 weeks seems very short.

BBC link from 2004. http://news.bbc.co.uk/1/hi/health/3614180.stm

BBC NEWS | Health | Loud music lung collapse warning

Doctors warn listening to loud music can lead to a collapsed lung.

AI6YR Ben Mar 19

@tempusfelix 😱

WideEyedCurious 🇺🇸 💙 🇺🇦 & 🇨🇦Mar 19

@ai6yr @tempusfelix I second that 😱

Darth Osler Mar 19

But sometimes not meh

https://pmc.ncbi.nlm.nih.gov/articles/PMC12656181/

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