Natl Med J India
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Case Reports
Pneumopericardium, pneumomediastinum and surgical emphysema in spontaneous pneumothorax.
Spontaneous pneumothorax leading to pneumomediastinum, pneumopericardium and surgical emphysema is a benign condition. Progression to the development of epidural pneumatosis is rare. We report a 19-year-old man who presented with dyspnoea and swelling of the chest wall following a bout of cough. ⋯ Close cardio-pulmonary monitoring is mandatory for complications and accompanying conditions. Most patients with uncomplicated spontaneous pneumomediastinum respond well to oxygen and conservative management. In this case, the patient's symptoms and severe tachypnoea prompted the insertion of an intercostal drainage tube.
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Case Reports Observational Study
Preoperative cardiology referral practices at a tertiary care centre: A retrospective observational study.
Background Preoperative consultations and testing add to healthcare costs. Unnecessary consultations lead to further testing and delay in surgery. Guidelines help us in clinical practice but are seldom followed. ⋯ Conclusion The majority of consultations were by surgeons and were not indicated according to the guidelines and did not have any impact on patient outcome. A large proportion of these patients had low cardiac risk index. As anaesthesiologists, we are best equipped to quantify risk and optimize a patient and should be the leaders of the perioperative period.