#186 Pneumothorax: 5 Pearls Segment

Core IM | Internal Medicine Podcast

Core IM Team

Mental Health, Education, Health & Fitness, Medicine

4.8 • 1K Ratings

🗓️ 25 August 2025

⏱️ 41 minutes

🔗️ Recording | iTunes | RSS

🧾️ Download transcript

Summary

Next time you’re squinting at a chest tube, feel confident you know exactly what to look for and why. Hear it explained in a way that really sticks!

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🔹 Transcript & Show Notes

Timestamps:

(02:50) | Xray vs. POCUS vs. CT for Pneumothorax Diagnosis

(07:29) | Do All PTXs Need Chest Tubes?

(11:55) | Explaining Pneumothorax to Patients

(14:58) | Understanding the Pleural Drainage System

(26:11) | Monitoring Air Leaks with the Water Seal Chamber

(32:27) | Managing Persistent Air Leaks

Tags: CoreIM, Internal Medicine, Pulmonology, Critical Care, Medical Education, 3-Chamber Drainage System, Endobronchial Valves and Pleurodesis

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Transcript

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0:00.0	It's an important topic to go over just because the three chamber system, I referred to as the black box, even though it's a white box, but it feels like a black box because people come into it, take a look at it. They're not really sure what they're supposed to be looking at, but they look at it anyway, and they walk out of the room. So I think it's important to kind of decipher the black box a little bit. That's Dr. Mihir Parikh, an interventional pulmonologist at BIDMC.
0:04.6	Welcome to the Cori.m. Five Pearls podcast, bringing you high yield evidence-based pearls. I'm Dr. Shrey Trevedi.
0:28.0	And I'm Alexander Castro, a third-year internal medicine resident of BidMC. Today, we're talking all things about
0:34.1	pneumothorax. All right, let's get into it. We test yourself by pausing after these questions, and remember, the more you test yourself,
0:40.7	the deeper your learning gains.
0:45.8	Pearl 1.
0:46.7	Diagnosis of neothorax.
0:48.3	Which imaging modality is the best for diagnosis and what types of pneumothorax are important
0:53.0	to recognize?
0:57.7	Pearl 2. Initial pneumothorax management.
1:00.3	Who gets a chest tube and who can be conservatively managed?
1:07.0	Pearl 3. Understanding the plural drainage system.
1:10.0	Do you have a step-by-step approach of looking through a plural drainage system?
1:17.6	Pearl 4. Air leak monitoring.
1:19.6	What is an air leak and how do you know how bad it is?
1:26.6	Pearl 5. Persistent air leaks.
1:28.5	When we diagnose an air leak as persistent, what are the options that we can use to treat it?
1:36.0	A quick word from our sponsor, Oakstone CME's ACP Mixap Audio Companion.
1:41.9	What would it feel like to have bite-sized mixap teaching ready to go anywhere
1:46.3	with you and earn CME credit at the same time? Take a listen. I found it very interesting,
1:51.9	the line that points out that observational studies suggest an increase in heart failure with insulin
1:58.5	therapy. That's something I hadn't known prior to this exercise.
	...

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