- A patient who came with history of fall while boarding a running local train under effect of alcohol
- He was brought to the hospital after 2 hours of injury by the local police
- When he came he was very restless and agitated
- There were no signs suggestive of any head injury
- Only sign we were able to elicit was marked tenderness over Right side of chest
- There were no obvious dilated veins over the neck, though a slight tracheal deviation was present
- A chest xray showed
- -Over expanded Right hemithorax
- -Shift of the mediastinum to the left side
- -Depression of the Right hemidiaphragm
- SPO2 was 78%. Immediately a needle thoracostomy was done. The SPO2 increased to 94%.
- An intercostal drain with under water seal was inserted.
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