Open pneumothorax

Question 1

Describe Open pneumothorax pathophysiology. (5)

Answer 1

1) Sucking chest wound
2) Large defect in chest wall
3) Bubbling and sucking/ hissing sound
4) Leads to rapid equilibrium of atmospheric and intrathoracic pressure
5) Impairs oxygenation and ventilation

Question 2

What are the signs on physical examination of an open pneumothorax? (6)

Answer 2

1) Respiratory distress
2) Tachycardia
3) Open wound on chest wall
4) Reduced chest movement
5) Hyper resonance on percussion
6) Reduced breath sounds

Question 3

What is the treatment of open pneumothorax? (2)

Answer 3

1) Three sided occlusive dressing (plastic)
2) Chest tube insertion (remote to site wound)

Question 4

1) How does 3 sided occlusive dressing work for open pneumothorax?
2) What will a complete dressing cause as a complication in patients with open pneumothorax?

Answer 4

1) Provides a flutter valve effect
- When patient expires, some air escapes from the open wound
- When inspire, the dressing creates a vacuum effect –> closing the wound
2) Avoid complete dressing, will create a tension pnuemothorax