PNEUMOTHORAX Flashcards
WHAT IS THE PATHOPHYSIOLOGY OF PNEUMOTHORAX?
air builds up in pleural space
WHAT ARE THE 4 TYPES OF PNEUMOTHORAX?
1) Spontaneous - primary (no lung disease) or secondary (lung disease- COPD, TB, lung cancer) 2) Traumatic - blunt trauma
3) Tension - emergency
4) Iatrogenic - post central line, pacemaker, intubation
WHAT ARE THE RISK FACTORS FOR PNEUMOTHORAX?
- pre-existing lung disease
- smoking
- trauma/ chest procedure
WHAT ARE THE SYMPTOMS OF PNEUMOTHORAX?
1) asymptomatic in young fit people
2) dyspnoea - sudden onset
3) pleuritic chest pain - sudden sharp chest pain upon inspiration and expiration
WHAT ARE THE SIGNS OF PNEUMOTHORAX?
1) reduced chest expansion
2) percussion - hyper-resonant
3) auscultation - diminished breath sounds on affected side
4) reduce vocal resonance on affected side
5) tachypnoea
6) cyanosis
7) tachycardia
8) hypotension
WHAT INVESTIGATION ARE CARRIED OUT FOR A PNEUMOTHORAX?
1) CXR - however should not be performed for suspected tension pneumothorax as delays necessary treatment
2) ABG - hypoxic patients + chronic lung disease, risk of respiratory failure from pneumothorax
WHAT IS THE MANAGMENT FOR PNEUMOTHORAX?
1) rim of air < 2cm in size and asymptomatic- discharge and review
2) rim of air >2cm and symptomatic - oxygen and aspiration (of air to achieve re-expansion), if unsuccessful then insert chest drain.
WHAT IS A TENSION PNEUMOTHORAX?
- Pneumothorax with tracheal deviation away from affected side.
WHAT ARE THE SIGNS OF TENSION PNEUMOTHORAX?
1) Hypotension
2) Tachycardia
3) Tracheal deviation away from affected side
WHAT IS THE MANAGEMENT FOR TENSION PNEUMOTHORAX?
1) Chest drain into affected side
WHERE SHOULD A CHEST DRAIN BE INSERTED FOR TENSION PNEUMOTHORAX?
1) Large bore intravenous cannula into 2nd intercostal space mid-clavicular line. Insert above rib as NVB runs below
WHAT ARE THE DIFFERENTIAL DIAGNOSIS FOR PNEUMOTHORAX?
1) Pulmonary embolism
2) Pleural effusion
WHERE SHOULD A CHEST DRAIN BE INSERTED FOR A PNEUMOTHORAX?
1) Large bore intravenous cannula into 5th intercostal space, mid axillary line. Insert above rib as NVB runs below
