pneumothorax Flashcards
what is the cause of pneumothorax?
Often spontaneous (especially in young thin men) due to rupture of a subpleural bulla.
It can be caused by asthma, COPD, TB, pneumonia, trauma
describe tension pneumothorax:
a type of pneumothorax that occurs when air in the pleural cavity builds up and causes pressure
pushes the trachea and squashing the opposite lung
treat immediately, don’t waste time with investigations
what is the difference between primary and secondary pneumothorax?
Primary Spontaneous Pneumothorax
-> occurs within a person that has normal lung function
Secondary Spontaneous Pneumothorax
-> occurs within a person that has a pre-existing lung condition (e.g. COPD, malignancy, sarcoidosis, CF, TB, pulmonary fibrosis)
describe traumatic pneumothorax:
a type of pneumothorax that occurs as a result of an injury (e.g. blunt, penetrating) to the chest wall of the lung
list the presentations of tension pneumothorax:
Shortness of breath
Tachycardia
Tracheal deviation away from the affected area
Reduced breath sounds in the affected area
list the presentations of spontaneous pneumothorax:
Sudden onset
Pleuritic chest pain
Breathlessness
Tall thin young men
Reduced chest wall movement and reduced or no breath sounds
Hyper-resonant percussion
+/- Underlying lung disease
+/- History of biopsy / line insertion / mechanical ventilation
how do you diagnose pneumothorax? what investigations do you use?
CXR (shows air in pleural cavity)
CT Thorax (if complex and uncertain)
what is the management options for Tension Pneumothorax?
Oxygen
Large-bore cannula insertion (2nd ICS midclavicular line)
Intercostal drainage (in the safe triangle, confirm with CXR)
what are the management for pneumothorax?
primary pneumothorax
-> Aspiration (through safe triangle area to avoid vital structures)
secondary
-> chest drain
last options
-> pleurodesis
