Pneumothorax Flashcards
What is a pneumothorax
Air gets into the pleural space separating the lung from the chest wall
Causes of pneumothorax
Spontaneous, trauma, iatrogenic and lung pathology
Iatrogenic causes of pneumothorax
Lung biopsy, mechanical ventilation or central line insertion
Investigation for pneumothorax
Erect chest Xray
When is no treatment required
No SOB or <2cm rim of air - as it should resolve.
When is aspiration required
SOB, and/or >2cm rim of air on CXR
How many times can aspiration be attempted
Twice
What happens if aspiration fails
Chest drain
What is a tension pneumothorax
One way valve into the pleural space that lets air in but not out, so more and more air gets trapped and increases pressure inside the thorax
Signs of tension pneumothorax
Tracheal deviation, reduced air entry to affected side, increased resonant, tachycardia and hypotension
Which side will trachea deviate to
Away from side of pneumothorax
Management of tension pneumothorax
Large bore cannula into the second intercostal space in the mid clavicular line
Where are chest drains inserted
Triangle of safety - 5th intercostal space, mid axillary line, anterior axillary line
What is done once chest drain is inserted
Chest XR to chest positioning
Typical patient with pneumothorax
Young, tall, slim man with sudden breathlessness and pleuritic chest pain while playing sports
