PTX

Question 1

RF for Spontaneous PTX

When are they unlikely?

Answer 1

Tall lean males
FHx

> 40 y/o unlikely

Question 2

S/S o Spontaneous PTX

Answer 2

Acute dyspnea
Labored breathing
ipsilateral pleuritic CP (sharp)
Tachycardia (most common finding)
Hypotension (common but not always)

Question 3

What are PE signs of Spontaneous PTX

Answer 3

Diminished breath sounds

hyper-resonance to percussion

Question 4

What would you see on a CXR if a pt has a spontaneous PTX

Answer 4

Visceral pleural line

Question 5

What is the tx for a spontaneous PTX

Answer 5

in ED <15% give supplemental O2 x6 hours (may fix smalll PTx)

Aspiration of air w/ chest tube/catheter/needle decompression

Question 6

What are some etiologies of Tension PTX

Answer 6

blunt trauma
MVC common cause in ED
(more impressive upon imaging)

Question 7

What are S/S of tension PTX

Answer 7

hypotension

hypoxia

Question 8

What are PE signs of Tension PTX

Answer 8

Absent breath sounds on side
Tracheal deviation
Hyperresonance to percussion
JVD
Tachy

Question 9

What are the signs on CXR of Tension PTX?

Answer 9

Shift of mediastinum to contralateral side

Question 10

What is the tx for tension PTX

Answer 10

Needle decompression 2nd ICS, 14-16” catheter)