Rapid accumulation

Rapid accumulation of significant quantities of intrapleural blood usually presents as an increasing effusion on radiography or as hypovolemia. Only a small-volume aspiration should be undertaken initially from any large-volume effusion, unless the patient has severe respiratory distress. When a large hemothorax is found, blood should be grouped and cross-matched, intravenous access should be established, and the patient should be examined and monitored. If there is a high volume of drainage or rapid accumulation of blood following aspiration, the surgeons should be contacted again as exploration of the chest is often necessary.

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