Tension Pneumothorax

Question 1

What is the presentation of tension pneumothorax?

Answer 1

• Shortness of breath (sudden onset)
• Pleuritic chest pain
• Unilateral reduced chest expansion
• Unilateral decreased breath sounds
• Unilateral hyper-resonance to percussion
• Typically young skinny males

Question 2

What specific signs make it a tension pneumothorax rather than just a pneumothorax?

Answer 2

• Hypotension
• trachea deviated away from affected side
• distended neck veins

Question 3

What is the management of a tension pneumothorax?

Answer 3

1. A-E assessment
   !! No delays for a CXR
2. Oxygen 15L non rebreath
3. Needle decompression: 2nd intercostal space mid-clavicular line
4. Insertion of a chest tube