Pneumothorax and haemoptysis Flashcards Preview

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Flashcards in Pneumothorax and haemoptysis Deck (12)
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1

Differentiate a tension pneumothorax from a large pneumothorax

Tension pneumothorax features haemodynamic instability (hypotension, tachycardia)

2

State the causes of a tension pneumothorax

Rib fracture Mechanical ventilation Failed central venous cannulation

3

Outline signs seen in tension pneumothorax

Respiratory distress Tachycardia Hypotension Raised JVP Tracheal shift Hyper resonant percussion Reduces breath sounds

4

Describe the urgent treatment of a tension pneumothorax

Temporary: Large bore needle with saline, or cannula decompression in 2nd intercostal space MCL of affected side. Definite: Chest drain

5

What is the triangle of safety?

Anatomical landmark for the insertion of chest drains.

  • Superior: base of axilla
  • Anterior: lateral edge of pectoralis major
  • Posterior: anterior border of latissimus dorsi
  • Inferior: horizontal line at level of nipple

6

Define massive haemoptysis

>240ml/24hr, or >100ml/24hr over consecutive days

7

What key questions should you ask if massive haemoptysis is suspected?

Nature and volume of haemoptysis Weight loss Drug Hx Smoking

8

List the commonest causes of massive haemoptysis

TB Bronchiectasis Carcinoma

9

List causes of massive haemoptysis

- Respiratory: infection, bronchiectasis, carcinoma - Cardiovascular: PE, ruptured aortic aneurysm, pulmonary oedema - Coagulation disorders: Drugs^, inherited conditions* - Trauma - Vasculitis (granulomatosis with polyangiitis) and Good pasture's ^ NSAIDs, Anticoagulants, Antiplatelets * Von Willebrands disease (vWF deficiency) and haemophilia

10

What is the key investigation and treatment of massive haemoptysis?

Ix: CT angiogram Tx: Embolism or ligation

11

When is a CT angiogram contraindicated?

Renal failure Contrast allergy

12

What would an empyema feature on aspiration?

Yellow turbid fluid pH <7.2 Low glucose High LDH