Diplomate, Board Certification of Emergency Medicine
Chairman, Department of Emergency Medicine Ma'ayenei
Hayeshua Hospital
The last thing I want to say about our lungs is the issue of
trauma. As lungs are filled with air, they have their own
response to trauma.
Pneumothorax is the leakage of air from inside the lung to
around the lung. This can be from any cause and is usually
from foreign bodies that puncture the lung. While outside of
our community that is usually from bullets or knives, by us
it is usually from traffic accidents lo aleinu or
medical error. It can also be from non-traumatic causes; and
sometimes chest x-rays on short of breath people reveal that
a leak has sprung in one of the lungs. However, this is a
rare occurrence unless cancer is present, again lo
aleinu.
The treatment is to evacuate the air with a large needle
that drains the air to a water device which prevents more
air from entering.
The most common trauma to the chest and lung is rib
fractures, but we have discovered that mostly these do fine
with adequate pain relief. No rib belts or taping is
necessary, indeed they may be dangerous because they don't
allow people to breathe as they should, and that can lead to
lung scarring. More than four fractures requires
hospitalization for pain control. If there isn't a suspicion
of four or more fractures, then rib films are unnecessary,
but a standard chest film may be recommended as rib
fractures may cause a pneumothorax.
Just a word on coughing up blood. Severe coughing can cause
a small amount of bleeding, as can bronchitis, but more
extensive bleeding such as coughing up a cupful of blood
points to more severe problems. One, which we haven't
mentioned, is tuberculosis. TB that is making a comeback as
it has become resistant to many of our antibiotics. This by
the way was the cause of death of Rabbi Nachman of Breslov,
who died at the young age of 36 from this disease while
tending to his wife, who had the same. Nowadays, death from
TB is rare, but it does have a characteristic x-ray so
persistent coughs should be checked out.
Treasure your lungs and take good care of them. How? Avoid
smoking, exercise, and drive safely. Now is that a new
message? Write me in care of the Yated.
A message from Glaxo, sponsor of this column.
Thinking about the foods that many people eat -- oil,
chickpeas, red hot techina, hamburger, also fried -- makes
me think immediately about Zantac. All these foods can cause
that gassy sour stomach that makes us regret we ever ate
them. No need to suffer when you can reach for Zantac and
put out that fire.
