pneumothorax Flashcards
define a pneumothorax
air within the pleural cavity
name the three types of pneumothorax and give examples of each
traumatic - stabbing, fractured rib.
iatrogenic - CT guided lung biopsy, pleural aspirate, trans-bronchial lung biopsy.
Spontaneous - primary: no underlying disease. Secondary: underlying lung disease e.g. COPD
name some signs and symptoms of a pneumothorax
Pleuritic chest pain
Breathlessness (can be minimal if primary)
Respiratory distress (especially if secondary)
Reduced air entry on affected side
Hyper-resonance to percussion (?)
Reduced vocal resonance
Tracheal deviation if tension (+/- circulatory collapse)
what is the definition of a small pneumothorax
<2cm of air at the axilla
Large - >2cm
where woud you place the catheter for the drain in a patient with pneumothorax
2nd intercostal space in the mid-clavicular line
name a common way of performing pleurodesis
using talc - causes an inflammatory reaction with subsequent pleural adhesion: highly effective.
when would surgical pleurodesis be considered
if it is a second pneumothorax on the same side or if it is the first contralateral event
what must be done with someone who has suffered a spontaneous secondary pneumothorax
should be admitted for observation +/- a drain. May require oxygen.
Caution relates to the fact that they are already suffering from an underlying lung condition ,
what is the recurrnce rate for pneumothorax
40% at one yera
what happens in a tension penumothorax
Develops when a chest wall or lung injury leads to the creation on a one-way valve into the pleural cavity. This progressive build-up of air causes increased intra-pleural pressure.
Air accumulates and compresses the lung, with shifting of the mediatinum. Venous return is impaired due to increasing thoracic pressure with cardiac output and BP falling. CAn lead to death very quickly.
what would you do in someone who you suspected of having a tension penumothorax
insert a venflon into the second intercostal space in the mid-clavicular line
