Pneumothorax

Question 1

What is a pnewwmothorax?

Answer 1

Air in pleural space

Question 2

What are the types of pneumothorax?

Answer 2

Spontaneous

• Primary
• Secondary

Traumatic
Tension
Iatrogenic

Question 3

What is a primary spontaneous pneumothorax?

Answer 3

Not associated with lung disease

Question 4

What is a secondary spontaneous pneumothorax?

Answer 4

Associated with lung disease

• asthma
• COPD
• TB
• pneumonia

Question 5

What are the symptoms?

Answer 5

Often no symptoms

Dyspnoea
Pleuritic chest pain

Question 6

What are the risk factors for a pneumothorax?

Answer 6

Pre-existing lung disease
Height 
Smoking 
Diving 
Trauma 

Connective tissue disorders

Question 7

What are the signs of a pneumothorax on examination?

Answer 7

Reduced expansion
Hyper-resonance
Reduced breath sounds

Question 8

How do you manage a primary pneumothorax?

Answer 8

If symptomatic + >2cm rim of air

• give O2
• aspirate

If unsuccessful, consider reaspiration or chest drain

Question 9

How do you manage a secondary pneumothorax?

Answer 9

Same as primary but lower threshold for ICD

Question 10

Where do you insert a chest drain?

Answer 10

Safe triangle = anterior border of latissimus dorsi, lateral border of pec major, line superior to nipple and apex below axilla

Question 11

What is a tension pneumothorax?

Answer 11

Air drawn into pleural space has no means of escape

Question 12

What are the signs of a tension pneumothorax?

Answer 12

Hypotension
Tachycardia
Deviation of trachea away from pneumothorax
Mediastinal shift

Question 13

How is a tension pneumothorax managed?

Answer 13

Large bore cannula into 2nd ICS midclavicular line