Pneumothorax

Question 1

Management of primary pneumothorax?

Answer 1

<2cm: Consider discharge and review in OPD in 2 - 4 weeks

> 2cm: Aspirate, 16 - 18G cannula

Question 2

Management of secondary pneumothorax?

Answer 2

> 2cm or breathless: chest drain
1 -2 cm: Aspirate
<1cm: Admit, high flow O2, observed for 24 hours

Question 3

Management of tension pneumothorax?

Answer 3

Aspirate

Question 4

In tension pneumothorax, what side does the trachea deviate to?

Answer 4

To the opposite side of the pneumothorax

Question 5

What are the SSx of tension pneumothorax?

Answer 5

Dilated neck veins
Cyanosis
Raised JVP
Dyspnoea
Tracheal deviation

Similar presentation to cardiac tamponade

Question 6

What is the pathophysiology behind tension pneumothorax?

Answer 6

May occur following thoracic trauma when a lung parenchymal flap is created.
This acts as a one way valve and allows pressure to rise.

Question 7

A patient has suffered a pneumothorax and recovered. He now wants to go on holiday. Give 2 pieces of advice relevant to his holiday travel.

Answer 7

Avoid air travel for 2 weeks after chest drain

Avoid diving completely