Unit 5 Breathless Moments: Katarina’s Emergency and the Power of the Respiratory System

Instructions

Read the case study below to follow Katarina’s real-life medical emergency involving a spontaneous pneumothorax—a sudden lung collapse that disrupted her ability to breathe. As you read, pay close attention to how the respiratory system normally functions and what happens when pressure builds up inside the chest cavity. Notice the critical role each healthcare professional plays in her emergency response, diagnosis, treatment, surgery, and recovery. After reading, be prepared to answer questions about anatomy, gas exchange, medical procedures, and the interdisciplinary teamwork involved in saving Katarina’s life.

The Critical Collapse: Katarina’s Unexpected Emergency

Katarina loved singing more than anything else. As the lead in her school’s spring musical, she had spent weeks perfecting each note and every line. But during the final dress rehearsal, something unexpected happened.

Katarina was warming up backstage when she felt a sharp pain in her chest—like someone had stabbed her with a needle just below her collarbone. She tried to take a breath, but the pain worsened. Her breathing became rapid and shallow. She dropped her water bottle and clutched her chest.

A castmate saw her stumble and called for help. Within minutes, the school nurse had called 911.

Emergency Response on Scene

When the EMTs arrived, they found Katarina sitting on the floor, pale and sweating, with obvious distress. Her breathing was fast, but her chest wasn’t rising evenly. One EMT placed an oxygen mask over her face while the other started checking her vitals.

“Katarina, can you tell us what you're feeling?” asked the paramedic gently.

“My chest hurts… I can’t breathe… more on the right side,” she gasped.

The EMT noted decreased breath sounds on her right side and visible tracheal deviation toward the left—a serious red flag. Based on the symptoms, the team suspected a spontaneous pneumothorax with tension.

“We need to transport immediately,” the paramedic said. As the ambulance raced to the hospital, oxygen was administered, and preparations were made for emergency intervention.

A Race Against Time in the ER

Katarina was rushed into the emergency department. The ER team, including nurses, a respiratory therapist, and an emergency physician, was ready. A quick bedside assessment confirmed the EMTs' suspicion. Her right lung had likely collapsed due to air collecting in the pleural space, pushing the lung inward and shifting her trachea.

The doctor quickly explained to her mother, “Katarina has a tension pneumothorax—a collapsed lung that's putting pressure on her heart and other lung. We need to relieve the pressure now.”

Using sterile technique, the ER physician performed a needle decompression—inserting a large-bore needle into the second intercostal space of Katarina’s chest. With a soft hiss, trapped air escaped, and Katarina’s breathing immediately eased.

Diagnostics and Further Treatment

Once she was stabilized, a radiology technician performed a chest X-ray to confirm the diagnosis and assess the lung’s condition. The image showed a significant pneumothorax with lung collapse on the right side.

A respiratory therapist helped monitor her oxygen levels while a pulmonologist was consulted for follow-up care. The next step was a thoracostomy—placing a chest tube between her ribs to allow continuous removal of air from the pleural space and give the lung room to re-expand.

A medical professional administering an injection into a patient's lower back. — KITTIPONG SOMKLANG / Shutterstock

The procedure was done at her bedside under local anesthesia. A nurse carefully taped the tube and connected it to a drainage system while monitoring for complications. Over the next day, the chest tube did its job. Her lung began to re-expand, but the pulmonologist noticed small blebs—weak spots on the lung that could rupture again.

A Surgical Solution

To prevent future collapses, Katarina’s pulmonologist consulted a thoracic surgeon, who recommended a video-assisted thoracoscopic surgery (VATS). This minimally invasive procedure would allow the surgical team to remove the blebs and perform a chemical pleurodesis—a technique to stick the lung to the chest wall to prevent further air leaks.

Katarina was scared but trusted the medical team. A nurse anesthetist explained the process and ensured her comfort. In the operating room, the surgical team inserted a small camera and instruments through tiny incisions in her chest. The procedure was successful, and she was transferred to the recovery room under the care of post-op nurses and respiratory staff.

Teamwork in Recovery

As Katarina recovered in the hospital, she received support from a variety of specialists. A respiratory therapist checked her oxygen levels regularly and coached her through breathing exercises. Pharmacists ensured she received proper pain management and post-surgery antibiotics. Laboratory technicians monitored her blood gases and complete blood count to ensure proper healing.

A pulmonologist visited each morning to review her chest X-rays and assess the healing process. After a few days, the chest tube was safely removed, and Katarina began walking short distances in the hallway, guided by a nurse. Her energy was coming back, and her breathing felt stronger each day.

Understanding What Happened

A few days into her recovery, the pulmonologist sat with Katarina and her mom to explain everything in simpler terms.

“Your lungs are like balloons inside your chest. They sit inside a space called the pleural cavity. Sometimes, small weak spots on the lungs—called blebs—can pop. When that happens, air leaks out and builds up around the lung, causing it to collapse.”

She nodded slowly. “That’s why it hurt so badly?”

“Yes,” he continued. “And when air keeps building up, it pushes everything in your chest over—including your heart and trachea. That’s what caused the dizziness and shortness of breath.”

He showed her a diagram of the respiratory system, pointing to the trachea, bronchi, alveoli, and diaphragm. “Normally, air travels down your trachea into each lung through the bronchi. It moves into tiny air sacs called alveoli, where oxygen enters your blood and carbon dioxide exits. But in your case, air leaked outside the lungs, not inside. That made it hard for your lungs to expand, and your body wasn’t getting the oxygen it needed.”

Follow-Up Care and Education

Before she was discharged, a respiratory therapist walked Katarina through a home care plan. She was instructed on breathing exercises to help keep her lungs healthy and on when to seek medical help if symptoms returned. She was also given guidelines to avoid high-risk activities like scuba diving or unpressurized flights until cleared by her surgeon.

A follow-up appointment was scheduled with the pulmonologist to monitor her healing. During that visit, another chest X-ray confirmed that her lungs were fully expanded and no new blebs had formed. The doctor praised her for staying calm and following the care plan closely.

Chest X-ray showing detailed branching of the lungs' bronchial tree. — Guzel Studio / Shutterstock

Katarina’s school nurse also received a summary of her condition. She was excused from strenuous activity for several weeks but was allowed to return to school and even attend rehearsals—though without singing just yet.

A New Perspective

Katarina’s brush with a serious respiratory emergency changed how she thought about her body—and the healthcare system. She had seen how many people it took to save her life: EMTs, ER nurses, doctors, radiology staff, respiratory therapists, lab workers, pharmacists, surgeons, and pulmonologists.

Her classmates were surprised to see her back so soon, but Katarina smiled. “I learned a lot about lungs—and teamwork,” she said.

She gave a short presentation in her biology class about her condition and showed her friends a diagram of how a spontaneous pneumothorax occurs. She even explained the role of Boyle’s Law in breathing—how pressure and volume in the chest shift with every breath.

By the time opening night arrived a month later, Katarina wasn’t just back on stage—she was stronger, more confident, and grateful for every deep breath she could take.

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