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A fit, elderly patient was brought into the ED resuscitation area following a fall while riding a bicycle, having sustained obvious head and chest injuries. A whole-body CT showed a large left pneumothorax, a small haemothorax component and fractures of left ribs 3–10. During chest drain insertion, as the pleural cavity was entered, the patient’s oxygen saturation decreased to between 78% and 85% on a 15 L non-rebreather mask with a falling BP to a systolic of 90 mm Hg. A portable …
Contributors PDMM wrote the manuscript, which was revised by KW and ET.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Provenance and peer review Not commissioned; internally peer reviewed.