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Warning-sign checks

Pneumomediastinum: when to get help

Go through these in order and stop at the first one that applies. If you are reading this for someone else, answer for them.

  1. 1

    Is any of this happening now?

    Call 911

    Seek emergency medical help for new chest pain with severe or worsening shortness of breath, fainting, confusion, blue or grey lips, heavy sweating, or a feeling that you may collapse.

    Do not drive yourself if you feel seriously unwell.

    Emergency assessment is also important for:

    • Severe chest or upper abdominal pain after forceful vomiting
    • Chest symptoms after a significant injury or medical procedure
    • Vomiting blood or coughing up blood
    • Rapidly increasing neck or chest swelling
    • Trouble swallowing saliva
    • Fever with worsening chest pain or breathlessness

    These features can occur with an esophageal tear, major airway injury, pneumothorax, infection, or pressure on the heart and lungs.

    Other emergency signs, for anyone
    • Someone who is struggling to breathe, gasping, choking, or cannot get words out
    • Someone who has chest pain, tightness or pressure lasting more than a few minutes
    • Someone who has sudden weakness or drooping on one side of the face or body, slurred speech, or sudden confusion
    • Someone who is unconscious, or cannot be woken
    • Someone who is bleeding heavily and it will not stop with firm pressure
    • Someone who has had a seizure that will not stop, or does not wake up afterwards
    • Someone who has lips or skin that look pale, blue, grey or blotchy
    • Someone who you believe has taken an overdose or swallowed something poisonous
  2. 2

    Is any of this happening?

    Be seen today

    If you have already been diagnosed and are recovering, arrange prompt medical review if pain or breathlessness is worsening, fever develops, swelling increases, or symptoms return after improving.

    Routine follow-up is appropriate when symptoms are steadily settling and none of the urgent warning signs are present.

    Use that visit to discuss recovery, asthma control, repeat imaging, and returning to work, exercise, flying, or diving.

Every sign above is quoted from the sofidex article on Pneumomediastinum. If you are not sure, err upward — it is always reasonable to be checked.