Pneumothorax

Question 1

Presentation of pneumothorax?

Answer 1

Asymptomatic, SOB or Chest pain.

Young thin men who smoke cannabis

Question 2

Investigation of choice in pneumothorax

Answer 2

CXR

Question 3

Management of primary spontaneous pneumothorax?

Answer 3

1) If <2cm + asymptomatic = discharge

2) If >2cm or symptomatic = admit for aspiration. If this fails, chest drain.

Question 4

Management of secondary spontaneous pneumothorax

• secondary means the person has underlying pulmonary disease

Answer 4

If 0-1cm + asymptomatic = oxygen + admit for 24 hours

If 1-2cm + asymptomatic = aspiration. If this fails; chest drain.

If >2cm or symptomatic = chest drain

Question 5

Tension pneumothorax

Answer 5

Air being drawn into pleural cavity with each breath with no route of escape during expiration due to air passing through a one way valve.

Trachea deviated to contralateral side.

Question 6

Management of tension pneumothorax:

Answer 6

Do not delay management for a CXR if you suspect.

1st: Needle aspiration: large bore annular into mid clavicular line 2nd intercostal space.
2nd: insert chest drain