pneumothorax Flashcards
what is a pneumothorax?
often spontaneous and due to a rupture allowing air to enter the air cavity
who is it common?
young thin men
what can cause it including conditions?
asthma copd TB pneumonia lung abscesses cystic fibrosis
symptoms
sometimes none sudden onset dyspnoea pleuritic chest ain Sharp pain sudden deterioration SOB
signs
reduced expansion hypoxia hyper-resonance diminished breathe sounds shifted apex beat AWAY p.thorax shifted trachea away from p.thorax
management
chest drain to remove excess air
surgery
other features of tension pneumothorax
deviated trachea and apex beat tachycardia hypotension distended neck veins respiratory distress
what sounds
unilateral hyperresonance to percussion
do you wait for check xray
not if suspected and esp if tension do not wai
t
definition of small and large
50% of long volume lost
>2cm distance between lung and chest margin on xray
management of normal and tension
normal - discharge and follow up in 1 or 2 weeks
tension 02 15l non rebreathable mask do not delay needle decompression 14-16G 2nd intercostal space md clavicle line syringe with 0.9% saline chest drain 5th ICS mid axillary line
management of recurrence
pluerdiesis or surgery
open pneumothorax defect to chest wall
flutter valve
haemthorax
iv fluids then chest drain
what is flail chest
2 or more ribs fractures in2 or more places
creating a mobile segment of chest wall
lung is crushed as of high force causing contusion
