Pneumothorax Flashcards
What does Marfan’s syndrome increase the risk for?
Acute aortic dissection or rupture
Which pneumothorax tends to have no tracheal deviation?
Primary pneumothorax
How is pneumothorax that is less than 2cm managed?
Conservatively or
Pleural aspiration
How is a pneumothorax 2cm or larger managed?
If symptomatic, they require a chest drain
When should follow up occur?
Outpatient clinic 2-4 weeks after presentation, and they require another chest image
How long are patients not permitted to fly on a plane?
7 days
How long are patients not permitted to dive for?
For life
Where is emergency needle compression located?
5th intercostal space, mid axillary line on the side of the pneumothorax
What is the first management of tension pneumothorax?
NEEDLE THORACENTESIS 5TH INTERCOSTAL SPACE MID AXILLARY LINE.
THEN, you would do a chest drain if they have co-morbiiies
What should always be performed prior to chest drain?
Needle throacentesis
When can needle decompression in 2nd ICS mid-clavicular line be performed?
Non traumatic pneumothorax
What to do for low risk pneumothorax?
Low risk is asymptomatic and less than 2cm. Depends on patient preferences:
Discharge with outpatient follow up in 2 weeks
OR
Aspiration with 16g cannula
What to do if initial management is unsuccessful for low risk?
if aspiration is unsuccessful, chest drain insertion
What to do for high risk pneumothorax?
Chest drain
What is the management of symptomatic patients with 2cm or larger pneumothorax?d
Depends o priorities
Conservative managmeent if wanting to avoid needle
Needle aspiration
Ambulatory devices
What are the ambulatory devices?
One way valve that allows air to eave pneumothorax and patient can be followed up as outpatient
Where is the location of pneumothorax?
Between visceral and parietal pleura
How does a tension pneumothorax present compared to classic pneumothorax?
Absent breath sounds
Tracheal deviation
Haemodynamic instability
What causes a non-deviated pneumothorax?
Primary spontaneous
How to assess chest drain fluid?
Fluid should be bubbling and swinging with breathing
What should be done for secondary pneumothorax?
Definitive management with chest drain or surgical pleurodesis
What shold be used for persistent air leaks in patinets not fit fo surgical intervention?
Chemical pleurodesis
What are the high risk characteristics for pneumothorax?
haemodynamic compromise (suggesting a tension pneumothorax)
significant hypoxia
bilateral pneumothorax
underlying lung disease
≥ 50 years of age with significant smoking history
haemothorax
