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Discussion

The ability to timely diagnose a pneumothorax is an important skill for the anesthesiologist. Pneumothorax can occur from various causes such as upper extremity blocks, subclavian or internal jugular vein central lines, mechanical ventilation barotrauma, surgical entry into the pleural space, or trauma patients who develop pneumothorax with institution of positive-pressure ventilation. Traditionally the chest radiograph has been the primary method for the diagnosis of pneumothorax. In the cases described, the anesthesiologist utilized ultrasound as the first imaging modality to assess for pneumothorax. Thoracic ultrasound detection of pneumothorax has been reported in emergency medicine, 1, 2 critical care, 3, 4 and military literature. 5, 6 The ultrasound examination of the chest is simple, economical, expeditious, and free of radiation. Using ultrasound to specifically rule out pneumothorax allows …