Pneumothorax Flashcards
what is it due to (primary)
rupture of subpleural bulla. often spontaneous (especially in young thin men).
other causes (secondary)
asthma, COPD, TB, pneumonia, lung abscess, carcinoma, CF, lung fibrosis, sarcoidosis, CT disorders, trauma, iatrogenic
what are some iatrogenic causes
subclavian CVP line insertion, pleural aspiration/biopsy, transbronchial biopsy, liver biopsy, +ve pressure ventilation
what is the definition of pneumothorax
air in the pleural space
symptoms
may be none, sudden onset dyspnoea, pleuritic chest pain
how would patients with asthma or COPD present
sudden deterioration
how would patients on mechanical ventilation present
hypoxia, increase in ventilation pressures
signs
reduced expansion, hyper resonance to percussion, diminished breath sounds
what happens to the trachea in tension pneumothorax
deviation away from affected side
management
chest drain
what is a tension pneumothorax
pleural tear acts as one way valve and air only passes on inspiration leading to a build up of positive pressure. rare unless on mechanical ventilator or nasal non invasive ventilation. impairment of cardio and respiratory
what is the result of a tension pneumothorax if not resolved
cardiorespiratory arrest
signs tension pneumothorax
resp distress, tachycardia, hypotension, distended neck veins, tracheal deviation away from side of pneumothorax, increased percussion note, reduced air entry/ breath sounds
treatment tension pneumothorax
insert needle to remove the air, then request CXR, then insert chest drain
