Notes

Bloods All Normal bar elevating WCC supporting infective cause

ABG all normal but key to know if any oxygen therapy. Patient is on 9L through
a full face mask. This roughly approximates to 58% Fi02 which in a healthy
patient should be doing a lot better.
CXR Details No name. No indication of AP/PA (PA look at Scapula). Rotation nil,
Inspiration, Penetration
Airway Deviated to the left
Breathing/Lungfields Complete whiteout opacity of entire left hemithorax. Right
lung field normal with intact lung markings to the full borders of the lung.
Cardiac Difficult to assess due to whiteout affecting right cardiac border but left
border implying cardiomegaly unlikely. Some mediastinal shift.
Diaphragm Left diaphragm normal. Right Diaphragm difficult to visualise.
Gastric bubble present
Everything else No visible fractures to ribs, sternum, clavicle or visible aspects
of shoulder joint. No lines, implantable or external devices
Differential Diagnosis Pleural Effusion, Pnemonia. Bonus for Empyema as
Next step in management ABCDE approach. Pleural tap and assess with Lights
criteria. Treat accordingly with some degree of argument for empiric antibiotic
therapy in light of elevated WCC.