Pneumothorax

Question 1

When does a pneumothorax occur?

Answer 1

Occurs when air accumulates in the pleural space

Question 2

What causes a tension pneumothorax?

Answer 2

If air enters the pleural space and cannot escape

Question 3

True or False…
A tension pneumothorax is a medical emergency.

Answer 3

True

Question 4

What is a pneumothorax often related to?

Answer 4

• Trauma
• Medical intervention (iatrogenic)

Question 5

How does primary spontaneous pneumothorax occur without?

Answer 5

Without any trauma or known respiratory illness

Question 6

How does secondary spontaneous pneumonia occur?

Answer 6

Known respiratory illness

Question 7

What are the S&S of a pneumothorax?

Answer 7

• Unilateral chest pain
• Absent breath sounds on auscultation over collapsed lung
• Increased HR
• Increased RR
• Shortness of breath (SOB)
• Cyanosis (i.e. blue lips, nails, skin)
• Reduced chest wall movement on side of collapsed lung
• Excessive sweating (tends to be tension pneumothorax)
• May have CV instability as pneumothorax progresses

Question 8

What are risk factors for pneumothorax?

Answer 8

• Known chronic lung disease (e.g. COPD, cystic fibrosis, pulmonary fibrosis)
• Trauma (e.g. Renal Tubular Acidosis (RTA), gunshot wound, stab wound)
• Mechanical ventilation
• Flying
• Scuba diving
• Inhaling drugs
• Smoking
• Marfan’s syndrome
• Tall, thin, male
• Pregnancy
• Family history or previous pneumothorax

Question 9

What are treatments for pneumothorax?

Answer 9

• Minor (May just watch and wait for it to resolve)
• Oxygen therapy
• Thoracentesis
• Chest drain
• Pleurodesis

Question 10

What is thoracentesis as a treatment for pneumothorax?

Answer 10

Fine needle between ribs to decompress air
(For a smaller pneumothorax)

Question 11

How is a chest drain used as treatment for pneumothorax?

Answer 11

Tube placed into pleural space, usually left for a few days until lung has re-expanded
(For bigger pneumothorax)

Question 12

How is pleurodesis used as a treatment for pneumothorax?

Answer 12

• Chemical or surgical, sticks lung to chest cavity.
• Makes any future lung surgery more difficult (e.g. lung transplant)

Question 13

What treatments can physios use for a pneumothorax?

Answer 13

• Oxygen therapy
• Breathlessness management
• Avoid positive pressure until pneumothorax has been drained or is draining
• Pain management
• Supported cough
• Airway clearance techniques (especially important in chronic lung disease)
• Mobilising (will prevent secondary complications such as DVT)