Pneumothorax (Respiratory) Flashcards
Who are pneumothoraces more common in?
Tall thin men, smokers, cannabis smokers and people with underlying lung disease.
What can a pneumothorax be secondary to?
Underlying lung disease e.g. COPD.
What are the signs and symptoms of a pneumothorax?
Acute onset pleuritic chest pain, SOB, hypoxia, tachycardia, hyperressonant percussion note, reduced expansion, quiet breath sounds on auscultation, Hamman’s sign (click on auscultation left side).
What are the sizes of small and large pneumothoraces?
Small <2cm rim of air, large >2cm rim of air (measured at hilar level).
What is the first line treatment in primary spontaneous pneumothorax and what are its advantages and disadvantages?
Aspiration, avoids chest drain but is time consuming and may fail if age >50 or secondary spontaneous pneumothorax.
What are the escalating steps in treatment
Chest drain, may need suction if air leak >48 hours, surgical intervention.
When is surgical intervention indicated?
Second ipsilateral ptx, first contralateral tpw, bilateral spontaneous ptx, persistent air leak, risk professions (pilots, divers) after first ptx.
What are the follow-up steps after a pneumothorax?
CXR until resolution, discuss flying and diving after pneumothorax, assess risk of recurrence and discuss smoking cessation.
What are the signs of a tension pneumothorax?
Acute respiratory distress, trachea deviated to opposite side, hypotension, raised JVP, reduced air entry on affected side.
What can cause a tension pneumothorax?
Ventilated patient (invasive or not), trauma, CPR esp PEA, blocked/kinked/misplaced drain, pre-existing airways disease, patients undergoing hyperbaric treatment.
What would you use in needle decompression and where would you insert it?
Large bore venflon; second intercostal space anteriorly, mid-clavicular line.
