If someone was diagnosed in a ER with a large pleural effusion, and a atelectasis of the left lower lobe (part of the lung collapsed) and dense consolidation in portions of the lingula and the left lower lobe, would they have to be admitted or would they be able to go home?
Maybe it would help if I listed the symptoms they were having that lead them to the ER to begin with.
Fever, cold chills, massive chest pain, and upper back pain, hoarse, really sever cough, coughing up Flem with blood in it, could not walk by himself, he had become that weak, crackling in his upper middle back, shortness of breath, could not take a deep breath, and alot of really bad pain, stabbing pain when he would try to cough, he was very pale in color, and the left side of his chest was swollen, he had been having these symptoms for four days.
Would someone that had these symptoms have to be admitted to a hospital or could they be treated at home with antibiotics and pain pills?
It sounds like the patient should be admitted for those symptoms. A couple of questions - What was his oxygen saturation and did he have a fever? What medications were ordered?
There are times when someone can be treated at home for a respiratory infection. For example, recently my son was having difficulty breathing,had a fever and was coughing up lots of phlegm. There were crackles in both lungs. I took him to the hospital and he had pneumonia, he was not admitted but, was sent home with meds and recovered without any problems.
If the person you mentioned was sent home was it an insurance issue? Unfortunately, many times people end up being sent home because they lack insurance. I'm not saying that's right, but it happens.
They sent him home, his temp was 101 and I am not sure about the oxygen, they never gave him any oxygen, but with in 24 hours he went to another ER and they rushed him to a major Hospital where he spent 4 days in ICU, then surgery, then 3 tubes coming out of his back and sides draining all of the infection that had caused a complete total collapsed lung on one side. A total of 10 days in the hospital and a 90,000.00 bill to the insurance Co. What I can't figure out is why would a doctor say they were going to keep him and monitor him all night then transport him the following morning to a lung specialist, then with in an hour totally change their mind, throw him out into the waiting room and give a call to come and pick him up. Causing a person to end up spending 4 days in ICU. I just can't figure out what would justify that kind of a decision, even if there wasn't insurance, Congress passed a bill back in 1986 that is suppose to protect people from being thrown out of ER because of lack of ability to pay.
The only thing I can suggest is to get a copy of his medical records. The H&P will tell you what the doctor decided and why. I can not even guess as to why you were told one thing about how they planned to treat him and then were told to pick him up and take him home.
If he had a collapsed lung it would seem that they would have kept him. Is it possible that it wasn't clear if it were collapsed and the doctor changed his mind about the diagnoses?
I can only guess, but it would merit further investigation. The O2 sat of 93% is acceptable. My son's O2 sats were in the 80's and his temp was 103 to 104. I did bring him home , but if he had gotten worse then I would have taken him back too.
I wanted to add that pleural effusion is fluid in the lung. Atelectasis is a collapse of the alveoli which are the tiny sacs in the lungs that promote air exchange.
Atelectasis is not the same as a collapsed lung. It may be that he developed a pneumothorax at some point. A pneumothorax is a collapsed lung where air has entered the pleural cavity and would require chest drainage tubes.
I agree that it would be a good idea to get a copy of his medical records from the first hospital visit...something doesn't sound right.
It could be that his lung collapse was secondary to whatever condition was making him sick in the first place. It's also possible that he initially could have had a collapse that was too small to be seen on x-ray (though it sounds like they may have been waiting on a cardiothoracic guy to come tube him the next day) and later went on to become a full collapse -- that would require an immediate insertion of a chest tube (small ones don't always require one).
Sats of 93 are good.
What was the main purpose of the surgery? To drain an infection or to reinflate the lung by sticking it to the chest wall? Let us know if you can find out.
I've had 2 pneumos and surgery, so if I can help you with anything, just ask. Hope things are better now...