pneumothorax Flashcards
Management for pneumothorax
If patient is symptomatic with high risk features ->
chest drain
Regular review
Discharge and reqire 2-4 weeks
High risk charcateristics of pneumothorax
Haemodynamic compromise
Significant hypoxia
Bilateral pneumothorax
Underlying lung disease
>50 years of age with significant smoking hisotry
Haemothorax
Is it safe to intervene?
Is the pnuemothorax a sufficinet size
Rapid symptom relief for pneumothorax - short term drainage
Needle aspiration
If resolved review in 2-4 weeks
If unresolved -> chest drain
Ambulaotry rapid symptom relief for pneumothorax
Ambulatory device
Regular review as outpatinet eveyr 2-3 days
Remove device when resolved
If stable -> OPD in 2-4 weeks
Conservative care pneumothorax PSP vs SSP
PSP - regular reciew as outpatient every 2-4 days
SSP review inpatient
Treatment for tension pneumothorax
Needle decompression in MidClavicularineL, 2nd ICS
What is primary spontaneous pneumothorax
tall young thin
Secondary spontaneous pneumothorac what is
underlying lung diseaseg COPD, asthma, lung cancer, marfans, PCP
When do pleurocentesis at 1st presentation
When recurrent pneumothorax would be life threatening eg sev COPD
What do if recurrent pneumothorax
Pleurocentesis +/- bullectomy via VAST
Conservative vs interventional mangament pneumothroax
Asymptomatic -> conservatice no matter size
Symptomacitc - check risk and safety
Iatrogenic causes pneumothoraz
Thoracentesis
Central venous catheter
CPAP
Lung biopsy
Signs and symptoms pneumothorax
Acute onset SOB and pleuritic pain
Hyperresonsnace on percussion
Diminished breath sounds
Decreased lung expansion
Increased RR
Tension - tracheal deviation away from affected lung
Tachycardia
Hypotension
Discharge advice pneumothorax
Smoking cessation
2 weeks before fly
Never scuba dive unless bilateral pleurectomy AND all normal investigations
