PLEURAL EFFUSION

Inspection

(+/-) Cyanosis, indicating severe hypoxia

(+/-) tripod position

(+/-) Tachypnea based on size of effusion

(+/-) Accessory muscle use depending on severity of pleural effusion

Palpation

Chest expansion decreased on affected side

Tracheal deviation away from affected side

Decreased tactile fremitus

Percussion

Dullness to percussion

Vital Signs

Pulse: tachycardia: HR>100

Respiratory rate: Tachypnea, >20 BPM

Decreased Oxygen saturation: <95%

Temperature: Pyrexia >100.4°F

BP: (+/-) elevated due to pain, can also be decreased due to underlying cause

Special tests

Egophony: "E" sounds more like an "A"

Whispered pectoriloquy: Whispered "1,2,3" is intelligible

Bronchophony shows abnormal vocal resonance

Auscultation

Decreased breath sounds over the effusion

Pleural friction/rubbing

Bronchial breath sounds heard over area of effusion

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