Pneumothorax & Hemothorax Flashcards
Pneumothorax
Collection of air in pleural space, b/w lungs and chest wall
Cause of Primary spontaneous Pneumothorax
Rupture of a subpleural bleb
RFs for PSP
- Smokers
- Males (thin & tall)
- FHx of PSP
Cause of Secondary Pneumothorax
- Underlying pathology - COPD, trauma & infection
- Iatrogenic
- Thoracocentesis
- +ve pressure ventilation
- Errors in subclavian central line placement
Tension pneumothorax
Effects of tension pneumothorax
- Hemodynamic instability
- Mediastinal shift
- Tracheal deviation away from affected lung
CFs of Pneumothorax (P-THORAX)
P- Pleuritic chest pain
T- Tracheal deviation
H- Hyperresonance
O- Occurs suddenly
R - Reduced breath sounds
A- Absent fremitus
X- X-rays showing collapse.
Dx of S. Pneumothorax in stable pts.
Chest xray in upright position
- White visceral pleural line that runs parallel to chest wall - indicates interference b/w lung & pleural air
- Loss of peripheral lung markings
Differentiating Spontaneous & Tension pneumothorax
Tracheal deviation
1. Spontaneous –> Towards affected lung
2. Tension –> Away from affected lung
Other SXS of Tension pneumothorax
- Shock
- Jugular venous distension
(Compression of SVC)
Tx of PSP
Small (<3cm)
- Supplemental oxygen + Observation
Large
- Chest tube
- Bandage over wound with 3 sides taped down
Tx of Secondary Pneumothorax
- Hospitalization + Drainage
Tx of Tension Pneumothorax
Needle decompression / Thoracostomy + Chest tube
- @ bottom of 2nd intercostal space @ midclavicular space
- avoids intercostal nerves & vessels & subclavian vessels
Hemothorax
Collection of blood in the pleural spce
Causes of Hemothorax
- Malignancy
- Aortic dissection
- TB
- Trauma
MATT
