Pneumothorax

Question 1

Describe the signs and symptoms of a pneumothorax. (9)

Answer 1

Could be asymptomatic
Breathlessness, pleuritic chest pain, cough
Dyspnoea, tachycardia, hypertension, reduced unilateral lung expansion, hyperresonant percussion note.

Question 2

Describe the treatment of a pneumothorax. (3)

Answer 2

Chest drain in the 4th/5th ICS, mid-axillary line, just above rib (bottom of ICS).

Question 3

Describe the cause of a primary pneumothorax. (3)

Answer 3

Tall, young men.

Sub-pleural bulla (air filled sacs) that burst allowing air into the pleural cavity.

Question 4

Describe the cause of a secondary pneumothorax. (6)

Answer 4

Secondary to lung disease (COPD, asthma, CF, cancer) or secondary to trauma (stab) or secondary to high pressure ventilation (iatrogenic).

Question 5

Describe a tension pneumothorax. (4)

Answer 5

A medical emergency that occurs when air enters the pleural space, but the increase in pressure when you try to expire causes the flap to shut so air cannot leave. Pushes mediastinum away.

Question 6

Describe the signs and symptoms of a tension pneumothorax. (9)

Answer 6

Severe distress, dyspnoea, pleuritic chest pain, tachycardia, hypotension, raised JVP, deviated trachea, displaced apex beat, hyper resonance.

Question 7

Describe the treatment of a tension pneumothorax. (3)

Answer 7

Immediate insertion of a plastic canula into the second intercostal space, mid clavicular line.