Author: Joseph Slowey, John Ryan, Brian Gaffney, Ben Shanahan / Editor: Stephen Sheridan / Codes: / Published: 23/10/2025
A male in his twenties presents to the Emergency Department (ED) with right sided chest pain and haemoptysis following chest trauma during a hurling match. He was sprinting to the ball when he collided with an opposition player. Immediately after the opposing players shoulder struck him in the chest, he complained of chest pain and was removed from play. During his sideline assessment he began to experience haemoptysis and was referred to the Emergency Department for further management.
He is vitally stable on arrival, ambulating without assistance and there are no immediate concerns for his airway. His sputum continues to be mixed with blood. His vital signs are as follows:
BP: 131/78 mm/hg
HR: 71 bpm
RR: 16 bpm
02: 98% on RA
The Initial ECG shows sinus rhythm and there are no clinical signs of pneumothorax on clinical assessment. Core bloods are within normal limits.
A chest x-ray is performed which reveals a non-specific abnormality behind the right cardiac silhouette. The patients haemoptysis resolves spontaneously, and he remains clinically well. However, this presentation combined with the abnormal x-ray findings present a diagnostic dilemma for the Emergency Medicine (EM) team. Given the departments significant background in sports and exercise medicine (SEM) related injuries, an EM Consultant sub specialising in SEM is available to manage he patient. A CT Chest is requested as the next step. As there is no on call cardiothoracic surgery service at the site, the Emergency Physician in charge (EPIC) decides on an admitting management plan through the use of telemedicine.
