Pneumothorax Flashcards
What is a pneumothorax?
A condition where air collects in the pleural space between the lung and chest wall
What is primary pneumothorax?
A pneumothorax which occurs with no obvious cause and in the absence of significant lung disease
What is secondary pneumothorax?
A pneumothorax that occurs in the presence of existing lung disease
Risk factors for pneumothorax?
Tall thin individual
Smoker
Symptoms of pneumothorax?
Pleuritic chest pain
SOB
Signs of pneumothorax?
Reduced expansion
Hyper resonant percussion
Quiet breath sounds on affected side
Tachycardia
Investigations for pneumothorax?
CXR - no peripheral lung markings
Management of primary pneumothorax?
- Rim <2cm and/or not breathless = consider discharge and review as OP in 2 weeks
- Rim >2cm and/or breathless = aspirate using 16-18G cannula
Success = rim <2cm or breathing improved
If no success –> chest drain + admit
Management of secondary pneumothorax?
- Rim >2cm and/or breathless = chest drain and admit
- Rim <1cm = admit, high flow O2 and observe for 24hrs
- Rim 1-2cm = aspirate using 16-18G cannula
Success = rim <1cm = admit, high flow O2 and observe for 24hrs
If no success –> chest drain + admit
What is a tension pneumothorax?
A pneumothorax accompanied by a mediastinal shift
Signs and symptoms of tension pneumothorax?
Severe breathlessness Tachycardia Hypotension Ipsilateral reduced/absent breath sounds Distended jugular veins Tracheal deviation from side of pneumothorax
Investigations for tension pneumothorax?
DON’T WAIT FOR CXR!
Manage immediately
Management of tension pneumothorax?
Immediate needle decompression by inserting a 14-16G cannula in the 2nd intercostal space mid-clavicular line
A chest drain would need to be inserted after the initial decompression
