Pneumothorax

Question 1

Measuring the size of a pneumothorax

Answer 1

A - Vertical distance between lung and thoracic cage at apex (>3cm = large)
B - Horizontal distance between lateral lung edge and chest wall at the hilum (>2cm = at least 50% collapse)

Question 2

Signs of clinical instability with pneumothorax

Answer 2

SBP < 90mmHg
Tachycardia
Tachypnoea
Hypoxaemia
Severe chest pain or breathlessness

Question 3

Advice on discharge for clinically stable pneumothorax

Answer 3

• Ensure patient able to seek medical attention with deterioration
• Review CXR every 2 weeks until resolved
• Refer to respiratory specialist if pneumothorax does not resolve or is recurrent

Question 4

Acute management of Pneumothorax

Answer 4

Adequate analgesia
O2 aim Sats > 95%
Unstable? Consider Intercostal catheter insertion (between 9th and 10th rib on mid-axillary line of ribcage)