FN: Pneumothorax Flashcards Preview

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Flashcards in FN: Pneumothorax Deck (19):
1

Definition

Accumulation of air in the pleural space with secondary lung collapse

2

Classification

Closed
Open
Tension

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Closed

Intact chest wall and air leaks from lung into pleural cavity

4

Open

Defect in the chest wall allows communication between PTX and exterior: may be sucking

5

Tension

Air enters pleural cavity through a one way valve and cannot escape - mediastinal compression

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Causes

Spontaneous: primary or secondary
Trauma
Iatrogenic

7

Spontaneous primary

No underlying lung disease --> young, thin men (ruptured subpleural bulla) or smokers

8

Spontaneous secondary

Underlying lung disease
1. COPD
2. Marfans, ehlers danlos
3. Pulmonary fibrosis, sarcoidosis

9

Trauma

Penetrating
Blunt rib fractures

10

Iatrogenic

Subclavian CVP line insertion
Positive pressure ventilation
Transbronchial biopsy
Liver biopsy

11

Presentation symptoms

Sudden onset
Dyspnoea
Pleuritic chest pain
Tension: respiratory distress, cardiac arrest

12

Signs in the chest

Reduced expansion
Resonant percussion
reduced breath sounds
Reduced VR

13

Signs tension

Raised JVP, mediastinal shift, raised HR, reduced BP

14

Signs crepitus

Surgical emphysema

15

Investigations

ABG
US
CXR

16

CXR shows

Translucency + collapse
Mediastinal shift
Surgical emphysema
Cause: rib fractures or pulmonary disease

17

Tension PTX management

1. Resusictate pt.
2. No CXR
3. Large bore Venflon into 2nd ICS, mid-clavicular line
Insert ICD

18

Traumatic PTX management§

Resuscitate pt.
Analgesia e.g. morphine
3-sided wet dressing if sucking
Insert ICD

19

Spontaneous

Aspirate (>2cm) then ICD

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