Pneumothorax Flashcards
tension pneumothorax aetiology
thoracic trauma
- lung parenchymal flap is created and acts as a one way valve and allows pressure to rise in the affected side.
tension pneumothorax treatment
decompression
- wide bore cannula
- in second intercostal space mid-clavicular line
- leads to formation of a ‘regular’ pneumothorax
pneumothorax signs & symptoms
hyper-resonant (percussion)
absent breath sounds (affected side)
tracheal deviation (away from affected side)
shock and respiratory distress
unequal chest expansion
HATS
pneumothorax risk factors
pre-existing lung disease:
- COPD
- asthma
- cystic fibrosis
- lung cancer
- pneumocystis pneumonia
connective tissue disease:
- Marfan’s syndrome
- rheumatoid arthritis
- ventilation
catamenial pneumothorax
spontaneous pneumothoraces occurring in menstruating women.
caused by endometriosis within the thorax
pneumothorax presentation
dyspnoea
chest pain: often pleuritic
sweating
tachypnoea
tachycardia
primary pneumothorax management
< 2cm & no dyspnoea
1. discharge
2. aspiration
> 2 cm or dyspnoea
1. chest drain
secondary pneumothorax management
<1cm
1. oxygen and admit for 24 hours
1-2 cm
1. aspiration
> 2cm or dyspnoea
1. chest drain
iatrogenic pneumothorax has less likelihood of recurrence than spontaneous pneumothorax
true
iatrogenic pneumothorax management
- observation
- aspiration
chest drain: ventilated or COPD patients
triangle of safety for inserting a chest drain?
5th intercostal space (inferior nipple line)
mid axillary line (lateral edge of latissimus dorsi)
anterior axillary line (lateral edge of the pectoris major)
- needle inserted above rib to avoid the neurovascular bundle that runs just below the rib.
- once the chest drain is inserted obtain a chest xray to check the positioning.
simple pneumothorax investigation
erect CXR
