Venting subcutaneous emphysema

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Dr. Andy McKibben is absolutely correct regarding treatment of pneumothorax 
with a chest tube and suction, then disconnecting the patient from suction to 
go to the CT, it allows for the lung to collapse again.   The CT is obtained 
after the physician has created an iatrogenic break in the therapy and OF 
COURSE one then sees a minimal or even large pneumothorax, which would NEVER 
have been seen if the PORTABLE CT had been performed in the ICU with the 
patient on suction.   As the patient returns to the ICU and is placed back on 
suction, the treatment of the pneumothrax and the hopes for a pleural 
symphsis (especially if there is an air leak) begins all over again.   If 
there is an air leak, and one hopes for pleural symphsis, it is important to 
have 7 days of uninterrupted suction for pleural symphsis to occur.  If at 
any time for any reason that suction in interrupted, then the clock starts 
all over again.   Every one who is on this web site can remember such cases 
which became very frustrating to the treating physicians.  The fact that they 
were frustrating was that those treating them do not understand these simple 
and long known principles.   

k

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