Pneumothorax * Flashcards
What is pneumothorax
Air in pleural space causing ipsilateral collapse
What are the two types of causes for Pneumothorax
Spontaneous
Traumatic
What are spontaneous primary causes of pneumothorax
No lung pathology
-affects tall thin men
What are spontaneous secondary causes
Marfans and Ehlers Danlos Asthma/COPD TB/Pneumonia CF/IPF Bronchial carcinoma
What are traumatic causes of pneumothorax
Iatrogenic -central line insertion -positive pressure ventilation Non iatrogenic -penetrating trauma -blunt trauma with fracture
What are the presentations of pneumothorax
Typically sudden SOB with sharp chest pain
Dyspnoea
Low breathing sounds and chest expansion
Hyperesonant percussion
What is the gold standard investigation for pneumothorax
Chest X ray
- Black fluid
- Tracheal deviation to opposite side
How would you manage primary Pneumothorax
NO SOB w/ pneumothorax <2cm = discharge
SOB w/ pneumothorax >2cm = aspirate (cannula under anaesthesia)
Intercostal drainage if Aspirate fails
How would you manage Secondary Pneumothorax
NO SOB w/ pneumothorax <1cm = Discharge
NO SOB w/ pneumothorax 1-2cm = Aspirate
SOB/Pneumothorax >2cm = intercostal drainage
What is tension Pneumothorax
Lung compression or RHF with pneumothorax
- Air can move in and not out (Increase intrapleural pressure)
- Medical emergency
How would you manage a tension pneumothorax
ABCDE
-Non rebreather mask
Immediate needle decompression @2nd IS midclavicular line
What is the pathology for pneumothorax
Pleural breach
