A 65-year-old male patient with a history of alcohol use presented with hemothorax after falling from a bridge. Clinical examination revealed dyspnea, chest pain, and diminished breath sounds, leading to a diagnosis of bilateral hemothorax. Interventions included bilateral pleural drainage and follow-up imaging was scheduled after two days.

1. HEMOTHORAX
M . A R AV I N D
D S M C H , P E R A M B A L U R

2. • 65 yrs/ M
• Trichy Government Hospital
• alleged H/O self fall from the bridge near Chathiram
bus stand under the influence of alcohol
• on March 22, 2016(Tue) around 8 pm

3. PRIMARY SURVEY
• Airway is patent
• Breathing: Dyspnoeic
• Circulation: Normal
• Disability & Neurological Assessment: Nil
• Exposure & Environmental Control: The patient was
undressed and the wounds are cleaned with saline &
betadine and surture is done

4. SECONDARY SURVEY
• C/O chest pain on both side
• C/O Difficulty in breathing
• C/O shortness of breath
• No H/O of LOC
• No H/O of ENT bleed, Seizures, vomiting
• No sigificant past & treatment history
• Known smoker & alcoholic

5. GENERAL EXAMINATION
• Conscious
• Oriented
• Obeys oral commands
• Palor +

6. VITALS
• BP: 90/ 60 mm Hg
• PR: 104 bts/min
• RR: 34/min
• SpO2: 90%

7. EXAMINATION
INSPECTION:
• Inc RR & dec depth of respiration (dyspnoeic)
• Rapid, shallow & labored breathing
• Chest wall is symmetrical
• No paradoxical movements
• No jugular venous distention
• laceration of 15*4 cm in the right parietotemporal region
• There is bruising of the face, eyelids and ant chest wall
• Trachea appears to be in the midline
• No external cervical injury/ hematoma
• No pain in moving the neck

8. PALPATION
• Tracheal position: midline
• There is tenderness on both sides
• rib crunches on both sides
• There is no adequate movements on both sides
• equal movements on both sides
• Subcutaneous crepitus present on both sides

9. SYSTEMIC EXAMINATION
•RS : diminished breath sounds on both sides
•CVS : S1, S2 heard
• No added sounds
•P/A : soft, bs+ , no guarding/ rigidity
•CNS: B/L PERTL +,B/L Pupils 3mm in size
• Obeys oral commands
• Moves all 4 limbs

10. • dullness on both sides of infra mammary,infra axillary,infra
scapular region
• bilateral hemothorax was diagnosed clinically
• under SAP Bilateral ICD was done
Percussion

12. Follow-up X-ray after 2 days