Pneumothorax Flashcards
Define Pneumothorax?
Air in the pleural space
What are some of the other variants of Pneumothorax?
Haemothorax - blood in the pleural space
Chylothorax - lymph
What are the three main aetiologies of Pneumothorax?
Spontaneous
Secondary
Traumatic
What is the spontaneous aetiology of Pneumothorax?
Occurs in people with typically normal lungs
Typically in tall, thin males
It is probably caused by the rupture of a subplerual bleb
What is the Secondary Aetiology of Pneumothorax?
Occurs in patients with pre-existing lung disease (COPD. Asthma, TB)
What is the traumatic aetiology of Pneumothorax?
Caused by penetrating injury to the chest Often iatrogenic (e.g. during jugular venous cannulation, thoracocentesis)
What are the risk factors for Pneumothorax?
Collagen disorders (e.g. Marfan’’s Syndrome, Ehlers-Danlos syndrome)
What is the epidemiology of Pneumothorax?
Annual Incidence: 9/100,000
Mainly in 20-40 yr olds
4x more common in males
What are the signs of Pneumothorax on physical examination?
There may be no signs if the pneumothorax is small Signs of respiratory distress Reduced expansion Hyper-resonance to percussion Reduced breath sounds
What are the signs of Tension Pneumothorax on physical examination?
Severe respiratory distress Tachycardia Hypotension Cyanosis Distended neck veins Tracheal deviation away from the side of the pneumothorax
What do we see on a CXR for Pneumothorax?
It will show a dark area of film with no vascular markings
Fluid level may be seen if there is any bleeding
Why do we do an ABG for Pneumothorax?
Check for hypoxaemia
What is the management plan for Tension Pneumothorax (EMERGENCY)?
Maximum O2
Insert large bore needle into 2nd intercostal space MCL
Up to 2.5 L of air can be aspirated
Stop if patient coughs or resistance is felt
Follow-up CXR 2 hrs and 2 weeks later
When is a Chest drain with Underwater Seal performed in Pneumothorax?
if:
Aspiration falls
Fluid in the pleural cavity
After decompression of a tension pneumothorax
Where do we insert a chest drain for Pneumothorax?
In the 4th-6th intercostal space midaxillary line
