Pneumothorax

Question 1

What is a Pneumothorax?

Answer 1

Accumulation of air within the pleural cavity.

Question 2

Red Flag Signs of Pneumothorax?

Answer 2

Sudden Dyspnoea

Sharp unilateral, pleuritic chest pain

Question 3

What is a 1ary Pneumothorax?

Answer 3

Occurs spontaneously

Question 4

What is a 2ndary Pneumothorax?

Answer 4

Occurs due to an underlying cause e.g. trauma, medical treatment, lung pathology

Question 5

Assessment of Pneumothorax?

Answer 5

1) Resp Exam - Unilateral diminished expansion, reduced breath sounds (affected side), Hyper resonant percussion.
1. 5) Tracheal Deviation (tension only)
2) CXR = 1st line diagnostic: Area without lung markings = line between lung and chest wall.

Question 6

What is a Tension Pneumothorax?

Answer 6

Pressure caused pushes mediastinum away. Severe impairment to respiration = emergency.

Question 7

Management of 1ary Pneumothorax?

Answer 7

1) No Dyspnoea AND Width <2cm (demarcation) at hilum = review in 2-4 weeks
2) Dyspnoea AND/OR >2cm width = aspiration + reassess, fail = chest drain.

Question 8

Management of 2ndary Pneumothorax?

Answer 8

> 50 + >2cm width = chest drain

<2cm width = aspiration, fail = chest drain

<1cm = O2 + 24h monitor

Question 9

Management of Tension Pneumothorax

Answer 9

1) Large Bore Cannula into 2nd ICS, mid clavicular line = relieve pressure
2) Chest Drain into ‘safe triangle’.
(5th ICS, Ant + mid axillary lines)