Non-tension pneumothorax Flashcards
What are the risk factors for a pneumothorax?
- pre-existing lung disease
- connective tissue disease: Marfan’s syndrome, rheumatoid arthritis
- ventilation, including non-invasive ventilation
- trauma
What is the difference between a non-tension(simple) pneumothorax to tension pneumothorax?
- Tension =one way valve, increases in size dramatically with every breath
- non-tension =air in pleural cavity but not increasing as no one way valve
What is the presentation of a non-tension pneumothorax?
*Asymptomatic
or minor symptoms of:
- dyspnoea
- chest pain: often pleuritic
- sweating
- tachypnoea
- tachycardia
Signs:
- reduction in lung expansion on affect side
- diminished breath sound on affected side
- hyper-resonate percussion
What is a spontaneous pneumothorax?
No know cause
-no predisposing lung disease/hx of trauma
What is a traumatic pneumothorax?
- Iatrogenic cause: ivasive medical procedures
* accidental -following direct injury to thorax
What is secondary pneumothorax?
Pneumothorax with pre-existing lung disease
How is a diagnosis of secondary pneumothorax made?
- if the patient is >50 years and has significant smoking history or
- if there is evidence of underlying lung disease on examination or chest x-ray,
What is the management of primary spontaneous pneumothorax?
- Conservative if less than 2cm (resolves by itself)
>safety netting
>review in 2-4weeks - Active if >2cm or significant breathlessness
>needle aspiration using 14-16G
What is the management o a secondary spontaneous pneumothorax?
Air less likely to settle spontaneously hence active management needed
>Admitted for 24hrs
>Oxygen
>needle aspiration (chest drain)
>persistent air leak discuss with thoracic surgeon
What investigations are done in a suspected pneumothorax?
- CXR
* ABG is dyspnoea
