What is the initial emergency department (ED) care for pneumomediastinum?

Updated: Apr 28, 2020
  • Author: Brian J Daley, MD, MBA, FACS, FCCP, CNSC; Chief Editor: Mary C Mancini, MD, PhD, MMM  more...
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Answer

Most patients with pneumomediastinum should be observed for signs of serious complications (eg, pneumothorax, tension pneumothorax, mediastinitis). If the pneumomediastinum occurred from the inhalation of cocaine or smoking of marijuana, observation in the ED for progression may be indicated.

A follow-up chest radiograph should be obtained in 12-24 hours to detect any progression or complication, such as pneumothorax. If no progression occurs at 24 hours and if no evidence of mediastinitis exists, the patient may be discharged.


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