Emergency stations

Question 1

Signs and Management of pneumothorax

Answer 1

PC: Sudden CP + SOB

Signs

• Resp distress
• Tacycardiac
• Hypotension
• Hypoxia
• o/e: unilateral reduced chest expansion + hyper-resonance + reduced air entry, trachea deviation, raised JVP

Mx: ABCDE

1. Ask someone to put out a peri-arrest call on 2222. If pt loses consciousness/no signs of life = crash call + commence CPR
2. Confirm side as above (trachea deviation, inc percussion note, absent breath)
3. Sterilise area and apply sterile gloves
4. Attach 10 ml syringe to 14-16G (orange/grey) cannula
5. Needle decompression: Insert into 2nd ICS, midclavicular line at 90 degrees
6. After initial decompression insert chest drain.