Pneumothorax Flashcards
Pneumothorax
Air in the pleural space (from outside or from the lungs)
Causes of pneumothorax
- Spontaneous (young thin men) due to rupture of sub-pleural bullae.
- Trauma.
- Iatrogenic.
What causes lung collapse?
Pneumothorax abolishes the transmural pressure gradient.
Signs of pneumothorax
Dyspnoea & pleuritic chest pain.
Signs of pneumothorax
Hyper-resonant percussion note, decreased/absent breath sounds, reduced expansion.
Signs of tension pneumothorax
Tracheal deviation
Investigations
CXR & ABGs
Treatment of pneumothorax due to trauma or mechanical ventilation
Requires chest drain
Treatment of pneumothorax
<2cm => observe + O2.
>2cm => Percutaneous aspiration.
2nd line: chest drain, 4/5th intercostal space, midaxillary line.
Tension Pneumothorax
Leak of air from lung into thoracic space creates a high pressure within the thoracic cavity, pushing the mediastinum away.
How does tension pneumothorax reduce cardiac output
Pressure rises so high that it prevents venous return though SVC.
Treatment for Tension Pneumothorax
High floe O2, needle decompression with large bore needle in anterior 2nd intercostal space a mid clavicular line => then chest drain.