Pneumothorax Flashcards
What are the types of Pneumothorax?
Simple/ Spontaneously;
- Primary
- Secondary
- Due to Trauma
(Spontaneous can turn into Tension Pneumothorax)
Compare Simple and Tension Pneumothorax
What causes Tension Pneumothorax
Simple;
- Patients are haemodynamically stable
Tension;
- Patients aren’t haemodynamically stable
- Caused by development of a one way valve system at site of breach in pleural membrane
Compare Primary and Secondary Spontaneous Pneumothorax
Primary;
- No underlying lung pathology
- (Rupture of underlying bulla thought to be the cause)
Secondary;
- Underlying lung pathology (COPD, Asthma, Cancer, Bronchiectasis etc.)
What are 4 risk factors for Primary Spontaneous Pneumothorax
- Male
- Young, Tall, Thin
- Family history of pneumonias
- Smoking
Describe 2 types of Traumatic Pneumothorax
Iatrogenic;
- Invasive medical procedures (Central lines)
Accidental;
- Direct injury to thorax allows air to enter pleural space
- Rib fractures can puncture the visceral pleura
How do Pneumothorax patients present?
- Sudden onset
- Pleurisy
- Breathlessness
How would a Simple/ Spontaneous Pneumothorax patient appear on examination?
- Trachea may be deviated
- Reduced chest movement (due to collapsed lung)
- Hyper-resonant on percussion
- Reduced/ absent intensity breath sounds
- Reduce vocal/ tactile resonance
List 4 symptoms of Severe Respiratory Distress
- Tachypnoea
- Tracheal deviation
- Tachycardia
- Hypotension
What are 3 ways of treating Pneumothorax
- Conservative treatment
- Pleural aspiration (max 2.5L)
- Chest drain
How is a Chest Drain inserted to treat a Pneumothorax?
(Attached to an Underwater seal on the other end, preventing air entering pleural cavity on inspiration, whilst draining air on expiration)
- Guided by Ultrasound
- Inserted into Safe Triangle
List the 4 borders of the Safe Triangle
- Superior: Base of Axilla
- Inferior: Rib 6/ IC space 5
- Anterior: Lateral edge of Pec Major
- Posterior: Lateral edge of Latissimus Dorsi
How would a Tension Pneumothorax patient present?
- Sudden onset Pleurisy
- Possible breathlessness
- Respiratory distress
- Cyanosis
- Hypotension (Compression of SVC/ IVC)
- Tachycardia
- Hypoxaemia
How would a Tension Pneumothorax patient appear on examination?
- Trachea deviated away from affected side
- Reduced chest movement
- Absent breath sounds (due to collapsed lung)
Not normally done due to urgency;
- Hyper resonant percussion
- Reduced vocal/ tactile resonance
Name and describe how is Tension Pneumothorax treated
- Emergency needle decompression
- Needle inserted into IC Space 2 in the Mid-Clavicular line
