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Hemothorax patient death can be caused because of the large blood loss and the occurrence of respiratory failure . Respiratory failure due to the large amount of blood in the pleural cavity pressure of lung tissue and reduced lung tissue that does ventilation. Then treatment hemothorax as follows: 1. Emptying of blood from the pleural cavity. Installed "chest tube" and is connected with the WSD system, this can accelerate the lung expands. 2. Stop the bleeding. If the installation of WSD, the blood still does not stop, then considered for thoracotomy. 3. General state of repair. Giving oxygen 2-4 liters / minute, the length adjusted to the clinical changes, better yet, if the monitored with blood gas analysis. Try to people with normal blood gases. Giving blood transfusion: seen from a decrease in Hb. As a benchmark can be used the following calculation, every 250 cc of blood (from patients with Hb 15 g%) can raise ¾ g% Hb. Given with a normal drop of about 20-30 drops / m...

Hemotorax is the presence of blood in the pleural cavity. Pathophysiology and Etiology Sharp trauma or blunt trauma. This can occur when blunt trauma can cause fractures of the ribs, resulting in a torn intercostal blood vessels and also cause a tear in the lung tissue. A torn aortic aneurysm Complications due to drug administration on pulmonary infarction antikoagulansia In patients with abnormalities of "hemorrhagic diathese". Complications in thoracic surgery. Clinical Symptoms Symptoms and complaints hemothorax depending on the weight and severity of trauma. Patients may complain of shortness of breath, chest pain, until the shock and anemia. Diagnosis 1. Anamnesa : A history of trauma to the chest, or after surgery. 2. Physical examination Found such signs in the pleural effusion . At the hospital hemitoraks reduced movement. Hemithorax percussion on the sick and faint sounds on auscultation, breath sounds audible reduced or disappear altogether. 3. Chest X-ray photo...

Outside the hospital. In light of spontaneous pneumothorax or pneumothorax simplex. Minimal or no complaints at all, are usually found by accident. The air in the pleural cavity will diresorbsi spontaneously. Because it does not require invasive measures. "Tension pneumothorax". Done in a sterile and carried out the stabbing in the sore area with a syringe the size of the largest. Stabbings in the space between the ribs into 2 in the front line of mid-clavicle. In young women (cosmetics) stabbings in the space between the ribs into 4 or 5 in the mid-axillary line. Then the needle tip covered with a sheet of thin rubber or thin plastic that can serve as a valve. Subsequently the patient was sent to hospital. I n the hospital. At the same place to do the installation of WSD, using trokar (troicar). It should be noted, that all actions undertaken SCARA sterile. WSD is removed, when the lung is expanding well and no complications after plastic hose clamped shut or 24 hours to pro...

The principle of treatment in empyema : 1. Emptying of the pleural cavity of pus 2. Antibiotics 3. Closure of the pleural cavity 4. Causal treatment 5. Additional treatment. 1. Emptying of the pleural cavity. a. Simple aspiration. Performed repeatedly using a large needle hole. This method is good enough to remove most of the pus or fluid from acute empyema is still runny. Losses such as these techniques often lead to "pocketed" empyema . Ultrasound can be used to determine the localization of "pocketed" empyema . b. Drainage is closed. Installation "= closed thoracostomy tube drainage (WSD)". Indications of this drain fitting, if the pus is very thick, pus is formed after 2 weeks and there has been piopneumotoraks. Installation of the hose should not be too low, the diaphragm is usually raised because of empyema . Select a hose that is large enough. If 3-4 weeks of no progress should be pursued by other means, such as in chronic empyema. c. Installation...

Empyema Thoracic is the presence of pus in the cavity / pleural cavity. Etiology of Empyema Thorasic I. Derived from the lungs: Pneumonia Lung abscess The existence of bronchopleural fistula Bronchiectasis Pulmonary Tuberculosis Lung fungus. II. From the extrapulmonary infection: Trauma of the brain Brain surgery Torasentesis Subfrenik abscess Due to amoebic liver abscess. Bacteriology Staphylococcal piogenes, at all ages, often in children. Piogenes streptococcus. Gram-negative bacteria (Pseudomonas aeruginosa,, Klebsiela, Bakteroides, E. coli, Proteus mirabilis) Anaerobic bacteria. Pathophysiology Of Empyema Thorasic Due to pyogenic bacteria invasion into the pleura arising acute inflammation, followed by the formation of serous exudates. With the number of PMN cells either living or dead, as well as increased levels of protein, the fluid becomes cloudy and thick. Fouled fibrin will form pockets of pus to localize it. Clinical Symptoms Clinical Course Divided into 2 stages, namely...

A. Conservative: 1. Control of acute and chronic infection, mucus secretion, airway obstruction and complications, such as: coughing up blood, respiratory failure and cor pulmonale, in order to prolong life, improve quality of life and prevent disease progression. 2. Antibiotics if there is infection. 3. Chest physiotherapy and postural drainage with forced expiratory technique for removing secretions. 4. Aerosols with physiologic saline or beta agonists prior to chest physiotherapy may facilitate the release of sputum / secretions. 5. Bronchodilators to improve airflow, helping mukosilia clearance and physiotherapy improve outcomes. 6. Corticosteroids when there is severe bronchospasm ( CPOD or Asthma Bronchiale ). B. Surgery: Indications of surgery: Local Bronchiectasis Haemoptoe massive. Tags : bronchiectasis pneumonia , what is bronchiectasis , bronchiectasis copd , bronchiectasis symptoms , bronchiectasis treatment , bronchiectasis definition , cystic bronchiectasis , Management b...

Clinical Symptoms of Bronchiectasis Chronic productive cough, continuous or repetitive. Coughing up blood, blood mixed sputum to massive coughing up blood. acute exacerbation accompanied by heat. Sputum mucoid, or purulent mukopurulen, when collected in a transparent glass look three layers: a layer of froth on top, the middle layer of mucus, pus and debris lining the bottom. Shortness of breath, and breath sounds. local wet crackles and settled. Wheezing can be found. Cachexia, cyanosis and clubbing in advanced cases. Diagnosis Diagnosis of bronchiectasis is established on the basic of: Complaints and symptoms were found on physical examination. Chest X-ray PA photo: normal in mild bronchiectasis. In severe cases, can seem "tram tracks" (two parallel lines like a tram tracks). The existence of the shadow ring when cut crosswise. If there is mucus plugging thick  --> linear density, or Y-shaped or V ("gloves-finger sign"). In cystic bronchiectasis, cystic cavit...

Bronchiectasis is abnormal and permanent dilatation of bronchi and cartilaginous being, accompanied by destruction of muscle and elastic components of the walls. Etiology and pathogenesis A bronchial wall inflammation, causing damage and dilatation. Contributing factors are: 1. Infection: primary and secondary. Primary or secondary infection, either repeatedly or continuously, by: bacteria, viruses, mycoplasma, and mycobacterial clearance mukosilia and will damage the airway epithelium. In children is often caused by: measles, whooping cough, severe pneumonia or aspiration. Primary tuberculosis is often also leads to bronchiectasis . Endobronchial tuberculosis causing necrosis, focal stenosis due to endobronchial inflammation, enlarged lymph nodes give emphasis or endobronchial obstruction, and scarring of the parenchyma causes distortion of the airway. 2. Inhalation of toxic chemicals or materials imunoaktif. Inhalation of toxic chemicals or materials imunoaktif or autoimmune react...

Lung Abscess Overview Etiology Pathogenesis Pathology Clinical Symptoms Diagnosis Physical examination Differential Diagnosis Complications Prognosis Lung abscess is a suppurative lesions accompanied by necrosis of tissue in it. Etiology Germs cause usually consist of a mixture of aerobic and anaerobic bacteria such as: peptokokus, peptostreptokokus, fusobakterium spp, bakteroides spp, which is the flora of oropharynx. An abscess can occur because: aspiration, complications of pneumonia , lung trauma wounds are infected, and infected with pulmonary infarction or originating from empyema . In the subsequent discussion only lung abscess caused by the aspiration to be described further. Pathogenesis Infection will easily arise when there predisposing factors, such as: A source of infection is an infection of the respiratory tract mouth, larynx tumors infected, infected bronchiectasis, and lung tumors are infected. The resistance of the airways that decrease, due to disorders such as la...

1. General management: Improving the general condition of patients with high-calorie high-protein diet and drink plenty of fluids. a. Antibiotics. Procaine penicillin G given 1.2 million units im every 12 hours + chloramphenicol 500 mg every 6 hours for 10-15 days. or Procaine penicillin G 1.2 million units i.m. every 12 hours + Metronidazole 500 mg every 6 hours for 10-15 days. or Clindamycin 600 mg every 8 hours for 10-15 days. b. Postural drainage and physiotherapy. The position of the body are arranged so that pus can come out by itself (due to gravity) or with the help of the physiotherapist. 2. Special Treatment: a. Bronchoscopy If pus is difficult exit, it is necessary to bronchoscopy to clear the airway and sucking pussy. b. Surgery When chemotherapy failed. A chronic abscess, cavity remains and sputum production remained there while the clinical symptoms are still present after adequate therapy for 6 weeks or the rest of extensive scar tissue that can interfere with l...

Indications of hospitalization is: 1. Patients with basic diseases 2. Patients with complications. General management. 1. Correction of underlying abnormalities (underlying disease) 2. Bedrest 3. Symptomatic medications, administered only if necessary, such as: 3 x 500 mg Paracetamol (in hyperpyrexia) Morphine 10 mg s.c. (If there is pain severe). 4. Maintain fluid and electrolyte balance with the help of intravenous fluids, 5% dextrose, normal saline or Ringer's lactate. 5. Selection of anti-infective drugs. Selection of antimicrobial drugs, should be based on sensitivity tests and sensitivity, but due to time and facilities greatly affect the success of this test, then giving more medicine based on empirical, as below: Special Treatment: 1. Pneumococcal pneumonia, Basic disease : elderly,  Chronic Obstructive Pulmonary Disease (COPD) , CHD, diabetes mellitus, alcoholism, post-influenza. Clinical features : sudden illness, high fever, chills, pleuritic pain, cough productive ...

Bacterial Pneumonia Overview Etiology Pathogenesis Pathology Clinical Symptoms Diagnosis Differential Diagnosis Complications Prognosis Bacterial Pneumonia Is an acute infection of lung parenchyma caused by bacteria. Pneumonia is an infectious disease other than that often obtained in the community (community acquired pneumonia), he also often acquired in hospital (hospital acquired pneumonia = nosocomial pneumonia). Pneumonia is the second difference, lies in the etiology and management. Etiology Bacterial pneumonia, can be basically caused by all kinds of bacteria, but most are caused by streptococcus pneumonia (80%), staphylococcus aureus, haemophilus influenza, pneumonia klebsiela germs while others are very rare. Pathogenesis The bacteria enter the lungs through: Aspiration of secretions from the oropharyngeal Inhalation of fine granules sputum (droplet) Channels of blood from an outside source of pulmonary infection (haematogenous). Pathology Germ that enters the alveoli caus...

Pneumothorax is the obtainment of air in the pleural cavity. Pathophysiology and Etiology Spontaneous pneumothorax due largely located superficial bullae rupture, and preceded by an increase in intra-pulmonary pressure, among others: cough hard or after blowing musical instruments, sneezing, straining, and others. The entry of air into the pleural cavity, through a tear in the visceral pleura. Bula congenital, predisposing especially in young males. Bula may also arise due to pulmonary tuberculosis , pneumoconiosis and bronchial obstruction. Traumatic pneumothorax can be caused by a "penetrating and non penetrating injury," either with or without rib fractures. "Surgical trauma" and "iatrogenic damage". Surgery can cause this type of pneumothorax. "Artificial pneumothorax" necessary for the treatment of hemoptysis in pulmonary tuberculosis as well as diagnostic measures for lung tumors. "Tension pneumothorax" due to "check valve...

Special Treatment of Bronchial Asthma : a. Mild asthma Limitations: Complaints arising tightness or cough less than two times a week, outside attacks asymptomatic sufferers. On physical activity may occur seranagn tightness or coughing which the period is short (<½ hours). Night asthma attacks rarely occur (<2 times a month). Pulmonary Physiology pasa asymptomatic state> / 80%, while the attacks may be decreased 20% or more. Treatment: 1. Beta 2 agonists: 2 sprays, may be repeated every 3-4 hours. 2. Cromolyn: can be added; before exposure to allergens, physical activity or other exposure. b. Moderate Asthma Limitations: Complaints arise more frequently (> 1-2 times a week), that affect activity and sleep sufferers. Attacks can last several days. Sometimes required emergency treatment. Pulmonary physiology during asymptomatic approximately 60-80%, while time attack decreases to 20-30% or may be even tougher. Treatment: 2 times daily inhaled corticosteroids (400-800 ug / day...

Procedure Of Bronchial Asthma Non-pharmacotherapy Provision of O2 Fluid Postural Drainage Avoiding exposure to allergens Guidance on patients and families about asthma, causes, and how to overcome them. Avoid the trigger factors (diet, medication, living habits, allergens) Immunotherapy / desentisisasi Physiotherapy breath, vibration and / or thoracic percussion, an efficient cough. Pharmacotherapy: 1. Bronchodilators: - Adrenaline; solution of adrenaline 1: 1000 subcutaneous 0.3 cc waiting for 15 minutes, if it has not subsided again given 0.3 cc if it has not abated, can be repeated once again 15 minutes later 0.3 cc. For children can be given smaller doses: 0.1 to 0.2 cc. Caution in elderly patients (coronair heart disease), hypertension, hyperthyroidism. -  Beta 2 agonists (oral, injection, inhalation / MDI, nebulizer) Orsiprenalin (alupent) 3 x 20 mg orally; subcutan 3 x 0.25 mg; 3 x 3 spray inhalation. Bricasma subcutan 3 x 0.5 cc. Heksoprenalin (Ipradol) 3 x 0.50 mg orally. ...