Pleural Effusion Lower Respiratory

Question 1

What are some clinical manifestations for pneumothorax?

Answer 1

• Mild Tachycardia and Dyspnea –> Severe Respiratory Distress
• ABSENT BREATH SOUNDS OVER AFFECTED AREA

Question 2

Describe the types of pneumothorax?

Spontaneous
Latrogentic
Open
Closed
Tension

Answer 2

Spontaneous- rupture of small blebs (air filled sacs) located on the surface of the lungs
-Blebs can occur in healthy individuals or as a result of lung diseases such as COPD, Asthma, Cystic Fibrosis, and Pneumonia

Latrogentic- Caused by medical procedure

Open- Air enters through an opening in the chest wall (getting stabbed)

Closed- No external wound and air enters pleural space from lungs

Tension- Accumulation of air in pleural space that does not escape (Life Threatening)

Question 3

What occurs in a tension pneumothorax?

Answer 3

The continued accumulation of air in the pleural space with no escape causes compression of the lung on the affected side and pressure on the heart and great vessels, PUSHING THEM AWAY FROM THE AFFECTED SIDE

Question 4

Define…

Hemothorax
Hemopneumothorax
Chylothorax

Answer 4

Hemothorax- Blood in pleural space (Requires immediate chest tube for evacuation of blood and blood can be reinfused)

Hemopneumothorax- Blood and air in pleural space

Chylothorax- Lymphatc fluid in pleural space

Question 5

What is pleurodesis?

Answer 5

Pleurodesis- Seals up the pleural space to prevent fluid or air from continually building up in it

Question 6

What is a Penetrating Chest Wound and what can you do to seal it up?

Answer 6

-Air enters the pleural space DURING INSPIRATION

-Use Vent Dressing used as Emergency Treatment
–> Occlusive Dressing Secred on 3 SIDES
(Prevents air from entering the pleural space during inspiration but lets air escape through the wound and from under the dressing)

Question 7

What causes paradoxical, uneven movements of the chest during breathing?

Answer 7

Flail Chest- resulting from the fracture of several consecutive ribs, in two or more separate places

Question 8

What is Cardiac Tamponade?

What are some symptoms?

Answer 8

Cardiac Tamponade- Blood rapidly collects in pericardial sac, compresses myocardium because the pericardium does not stretch and prevents ventricles from filling

• Muffled distant heart sounds
• Hypotension
• Jugular Vein Distention (JVD)
• Increased Central Venous Pressure

Question 9

What Emergency Management Interventions should you do with a patient with Chest Trauma?

Answer 9

• Assess Airway, Breathing, Circulation
• Administer high flow O2 to keep SpO2 >90%
• Establish IV access with two large bore catheters to begin fluid resuscitation
• Remove clothing to Assess Injury
• Cover Sucking Chest Wound with nonporous dressing taped on 3 sides (Vent Dressing)
• Stabilize Impaled Objects
• Place in Semi-Fowler’s Position or on Uninjured Side
• Administer Analgesia
• Prepare for Emergency Needle Decompression (Thoracentesis)

Question 10

What equipment should you use to treat a pneumothorax?

Answer 10

Chest Tube with water-seal compartment

• reestablishes negative pressure
• helps lung reexpand
• Removes Air or Fluid from Pleural and/or Mediastinal Space

Flutter (Heimlich) Valve

• Used for emergency transport and for small to moderate pneumothorax
• Increased patient mobility
• Must vent any attached drainage bag

Question 11

What do you need to do before, during, and after removing chest tubes?

Answer 11

• Premedicate prior to removal
• Valsalva maneuver during removal
• Apply occlusive dressing
• Chest X-Ray is done
• Monitor for Respiratory Distress