Pneumothorax

Question 1

What clinical sign indicates a tension pneumothorax?

Answer 1

Deviated trachea

Question 2

What is a primary pneumothorax?

Answer 2

A pneumothorax occurring in normal lungs, often spontaneous

Question 3

What is a secondary pneumothorax?

Answer 3

A pneumothorax occurring in lungs with underlying disease e.g. COPD, cystic fibrosis

Question 4

How might a patient with a pneumothorax present?

Answer 4

Sudden onset pleuritic chest pain
SOB
Hypoxia

Question 5

Which patients are most likely to suffer from a spontaneous pneumothorax?

Answer 5

Tall, thin men

Question 6

What are the signs of pneumothorax?

Answer 6

Unilateral hyper-resonance on percussion
Asymmetrical chest expansion
Quiet breath sounds on auscultation

Question 7

What are the signs of a tension pneumothorax?

Answer 7

Deviated trachea
Hypotension
Raised JVP
Reduced air entry on affected side

Question 8

What is the emergency treatment of a tension pneumothorax?

Answer 8

Large bore needle inserted into 2nd intercostal space

Should hear large hiss of air

Question 9

What is the standard first line treatment for pneumothorax?

Answer 9

If greater than 2cm in patients with no underlying disease, it can be aspirated with a needle. If this is unsuccessful, a chest drain can be used
In patients with underlying disease, <2cm pneumothorax can be drained by needle aspiration