The chest radiograph showed the presence of a meniscus in the right chest together with a blunt-ed right costophrenic angle. Which of the following procedures would you recommend at this point to treat Ms. Paul?
a. Anterior chest tube thoracostomy
b. Chest needle decompression
c. Video-assisted thoracoscopy (VAT)
d. Posterior chest tube thoracostomy
ANS: D
The presence of a meniscus in the chest radiograph is indicative of a large pleural effusion. Large pleural effusions need to be drained either by needle aspiration during a thoracentesis for spon-taneously breathing patients or by the insertion of a posterior chest tube. Anterior chest tubes are used for a pneumothorax.
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