Pneumothorax - Treatment & Management

Question 1

Simple Pneumo (P or S) Management

Answer 1

• O2 if

Question 2

Tension Pneumo Management

Answer 2

• Needle Thoracentesis
• 14 gauge cannula (orange)
• Inserted at 90 degrees
• 2nd intercostal space, mid clavicular, above 3rd rib
• Syringe attached to cannula, aspirate as you go in
• Repeat if needed – move laterally
• Oxygen
• Any attempt at a needle decompression should be followed by a chest drain or thorocostomy
• Most conscious people will be unwilling to allow you to decompress their chest
• Ensure they know the risks of not having it done
• Transport to nearest receiving hospital with pre alert
• Treat with O2
• ? Pain Treatment?

Question 3

Pneumo - To move patient

Answer 3

Chair or trolley to avoid exacerbating the injury and requiring extra work of breathing

Question 4

On arrival at hospital

Answer 4

ON Arrival at Hospital: 
o	Take in O2
o	Take in BVM in case needed
o	Take in monitoring if required
Handover: 

Many hospitals now promote the use of ATMIST in this situation, as it facilities a rapid, accurate handover.
o Age (name for handover)
o Time of onset
o Medical complaint / history
o Investigations (brief examination of findings)
o Signs* (first set and significant changes)
o Treatment

Question 5

Pneumo - ASHICE

Answer 5

o Age - Patients age
o Sex – Male/Female
o History - What has happened
o Injuries sustained – ?Tension Pneumothorax
o Condition - Patients vital signs: BP, Pulse, Respirations, O2 saturation, Glasgow Coma Score, Is the patient cannulated, Intubated and any medications given to patient e.g. Oxygen, needle thoracentesis, BVM etc
o Estimated Time of Arrival to Hospital