Pneumothorax, Hemothorax, and Tension Pneumothorax Flashcards
(15 cards)
What are the primary actions in the management of pneumothorax, hemothorax, and tension pneumothorax?
Administer 100% oxygen, call for help, maintain airway patency, convert to manual ventilation if on mechanical ventilation, perform needle decompression for hemodynamically unstable patients, and place a chest tube with chest X-ray confirmation.
What are the secondary actions in the management of pneumothorax, hemothorax, and tension pneumothorax?
Avoid nitrous oxide, cover penetrating chest wound with airtight occlusive dressing, monitor and treat anemia and hypovolemia, obtain arterial blood gas, chest X-ray, CT scan, CBC, and coagulation studies, and implement assisted ventilation strategy after chest tube placement.
What is pneumothorax?
Air trapped within the pleural space, disrupting the pressure gradient between the pleural and intrapulmonary spaces, leading to lung collapse and hypoxemia.
What are the causes of pneumothorax?
Trauma, spontaneous (ruptured bullae or blebs in COPD), iatrogenic (central line, barotrauma, excessive PEEP), and infectious (tuberculosis, pleural effusion).
What is tension pneumothorax?
Progressive accumulation of air in the pleural space causing mediastinal shift, compressing heart and lung tissue, leading to reduced cardiac output, respiratory distress, and hypoxemia.
What is hemothorax?
Blood accumulation within the pleural space, causing compression of the lung and potential cardiovascular compromise.
What are the neurologic signs and symptoms of pneumothorax, hemothorax, and tension pneumothorax?
Altered level of consciousness.
What are the respiratory signs and symptoms of pneumothorax, hemothorax, and tension pneumothorax?
Absent/decreased breath sounds on affected side, cyanosis, decreased or altered EtCO₂, dyspnea, hemoptysis, hypoxemia, increased EtCO₂/PaCO₂, increased peak airway pressure, pallor, paradoxical respiration, radiographic translucency on affected side, subcutaneous emphysema, tachypnea, and tracheal deviation away from the affected side in tension pneumothorax.
What are the cardiovascular signs and symptoms of pneumothorax, hemothorax, and tension pneumothorax?
Chest pain, hypertension (early sign), hypotension (late sign), jugular venous distention (tension pneumothorax), narrowed pulse pressure, potential cardiovascular collapse with positive pressure ventilation, and tachycardia.
What are some differential diagnoses for respiratory issues?
Atelectasis, bronchospasm, COPD, empyema, hypoventilation, pneumonia, and pulmonary embolism.
What are some differential diagnoses for cardiovascular issues?
Acute coronary syndrome, acute pericarditis, cardiac tamponade, intraoperative hemodynamic instability, and myocardial infarction.
What are some musculoskeletal differential diagnoses?
Costochondritis, diaphragmatic injury, intercostal muscle spasm, and obesity or excessive chest tissue.
What are some other considerations in differential diagnosis?
Anaphylaxis, esophageal spasm, and equipment malfunction.
What diagnostic tests are used for pneumothorax, hemothorax, and tension pneumothorax?
Baseline and serial ABGs, chest X-ray and CT scan, auscultation, coagulation studies, consultations, hemoglobin/hematocrit, and point-of-care ultrasound.
What does point-of-care ultrasound look for in pneumothorax?
Lung point, absence of lung sliding, and absence of B-lines.
