Pneumothorax

Question 1

Pneumothorax

Answer 1

air in the pleural space

Question 2

types

Answer 2

primary
secondary - underlying condition
tension - air gets in through one valve

Question 3

RF

Answer 3

asthma
COPD
male, tall, slim
use of cannabis

Question 4

signs

Answer 4

sudden pleuritic chest pain
dyspnoea
pain worse on expiration

accessory muscles used
tracheal deviation
hyper-resonant on percussion
reduced chest expansion

Question 5

investigations

Answer 5

examination

CXR

Question 6

management

Answer 6

primary:
no SOB and less than 2cm - send home
SOB or >2cm - aspiration

secondary:
no SOB and less than 1cm - send home
no SOB and 1-2cm - aspirate
SOB or >2cm - drainage

tension:
needle compression at 2 intercostal space, mid-clavicular

Question 7

complication

Answer 7

aortic dissection

Question 8

when do you immediately give chest drain in a primary or secondary pneumothorax

Answer 8

haemodynamically unstable

bilateral pneumothorax

Question 9

discharge advice

Answer 9

smoking cessation
travel a week after
no scuba diving

Question 10

how do you know the chest drain is fitted correctly

Answer 10

water seal rises on inspiration and falls on expiration