Pneumothorax Flashcards
what is pneumothorax
air within the pleural cavity
what is a haemothorax
blood within the pleural cavity
what is chylothorax
lymph within the pleural cavity
what are the causes of a pneumothorax
spontaneous and traumatic
what is a spontaneous pneumothorax and what may have caused it
it is pneumothorax that occurs in patients with normal lungs.
usually occurs in tall, thin men
what is secondary pneumothorax
Occurs in patients with pre-existing lung disease (e.g. COPD, asthma, TB)
what is traumatic pneumothorax
penetrating injury to the chest; can be through cannulating the JV
what are some risk factors for pneumothorax
Collagen disorders (e.g. Marfan’s syndrome, Ehlers-Danlos syndrome)
epidemiology of pneumothorax
4x more common in males
mainly 20-40 yr olds
presenting symptoms of pneumothorax
Sudden-onset breathlessness
Pleuritic chest pain
Distress with rapid shallow breathing in tension pneumothorax
presenting symptoms of a tension pneumothorax
patients are distressed with rapid laboured respirations, cyanosis, profuse diaphoresis, and tachycardia.
signs on physical examination of pneumothorax
ipsilateral reduced breath sounds
ipsilateral reduced chest expansion
hypoxia
ipsilateral reduced tactile vocal fremitus
ipsilateral hyperresonance on percussion
what happens to the trachea in a tension pneumothorax
the trachea will shift towards the opposing side of the pneumothorax (contralateral deviation)
signs of tension pneumothorax
tachycardia, hypotension, contralateral tracheal deviation
investigation for pneumothorax
CXR and ABG (hypoxia)
what findings will you see on a CXR
It will show a dark area of film with no vascular markings
Fluid level may be seen if there is any bleeding
management of a pneumothorax
The patient should be approached using the ABCDE algorithm. High flow oxygen (15 L/min) via a non-rebreather mask should be administered.
Emergency management is with immediate needle decompression using a 16-gauge cannula inserted at the second intercostal space, mid-clavicular line, on the affected side.
Note that the needle should be inserted just above the third rib, to avoid damaging the neurovascular bundle. The needle decompression acts as a bridge before insertion of an intercostal chest drain.
