Pneumothorax Flashcards
what is it
collection of air in pleural space resulting in collapsed lung
what are primary cause
normal lungs then apical bullae rupture
what is secondary cause
pre-existing lung diseases eg smoking, severe asthma, COPD, marfans
who is it common in
those with existing respiratory conditions, cannabis users, smokers and tall, thin men
what are symptoms
sudden onset of pleuritic pain
SOB
tachycardia
what are signs
hyper-resonant percussion note
reduced expansion
quiet breath sounds on auscultation
hamman’s sign (click on auscultation at left side)
how is it diagnosed
CXR - small <2cm rim of air, large >2cm
ABG - hypoxia
treatment if <20%
observe, air will usually reabsorb
treatment if 20-50%
needle aspiration using 16-18G cannula sited in 2nd IC space, mid clavicular line
treatment if >50%
chest drainage - intercostal small bore drain in 5th IC space, mid auxillary line
treatment if recurrence
pleurodesis/pleurectomy
what is the follow up
CXR
discuss flying and diving (not for 6 weeks)
general recurrance risk
smoking cessation
what is tension pneumothorax
medical emergency
can lead to cardiac arrest due to one way valve mechanism (between pleural layers) resulting in increased pressure in pleural space
what is signs of tension pneumothorax
tracheal deviation mediastinal shift to opposite side hypotension raised JVP reduced air entry
what is treatment of TP
O2 and needle compression usually with large bore venflon in 2nd intercostal space
