In a patient with subcutaneous emphysema due to severe coughing spasms, what is the next step in management?

The next step in managing a patient with subcutaneous emphysema resulting from severe coughing spasms is to perform a chest X-ray to rule out pneumothorax. Subcutaneous emphysema can occur when air enters the subcutaneous tissue, often due to a rupture in the airway or lung parenchyma. A chest X-ray is a rapid and effective method to assess for the presence of pneumothorax, which can happen concurrently with subcutaneous emphysema. Detecting pneumothorax is critical, as it can lead to significant respiratory compromise and may require intervention such as chest tube placement.

Other imaging modalities like a CT scan could provide more detailed information but are not immediately necessary unless there is strong suspicion of a more severe underlying injury or if the chest X-ray is inconclusive. While the administration of antibiotics might be considered if there is concern for infection, it is not indicated as an immediate step for subcutaneous emphysema itself, as this condition is primarily mechanical rather than infectious. Observation and follow-up might be appropriate in certain cases, but given the potential complications of pneumothorax, initial imaging is essential to ensure patient safety and appropriate management. Therefore, ruling out pneumothorax with a chest X-ray is