Recognize
Common ICU indications include pneumothorax, empyema/complicated parapneumonic effusion, hemothorax and selected large symptomatic effusions.
procedures / devices
Deterioration with a Pleural Drain
New hypoxemia, air leak, bleeding or poor drainage in a patient with a chest tube.
Act
Ultrasound identifies a safe window, diaphragm and loculations and reduces complications for pleural fluid procedures; pneumothorax drainage site/technique depends on urgency and anatomy.
Reassess
Reassess trajectory, organ support, competing diagnoses and failure of first-line therapy; escalate early when physiology is worsening.
Evidence status
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