Pneumothorax (Pleural/Pulmonary Disease) Flashcards
What is meant by the term pneumothorax?
An abnormal collection of air in the pleural cavity
What can cause a pneumothorax?
- Often occurs spontaneously, especially in tall, thin men
- Trauma
- Iatrogenic (e.g. CVP line, positive pressure ventilation)
- Respiratory (e.g. asthma, pneumonia, COPS, CF, carcinoma, ILD)
- Connective tissue disorders (e.g. Marfans, Ehlers Danlos)
What are the main symptoms of a pneumothorax?
SOB and pleuritic chest pain
What are the main signs of a pneumothorax?
Reduced expansion, hyper-resonant percussion, reduced breath sounds and hypoxia
What investigations could be done if a pneumothorax is suspected?
ABG and CXR
When should an ABG be done for a pneumothorax?
If hypoxic
When should an CXR be done for a pneumothorax?
Only if a non-tension pneumothorax is suspected
What CXR results would be indicative of a pneumothorax?
Peripheral loss of lung markings
What treatment should be given for a primary spontaneous pneumothorax less than 2cm in size with no associated symptoms?
Discharge
What treatment should be given for a primary spontaneous pneumothorax greater than 2cm in size or with associated symptoms?
Admit for aspiration and if this fails then do a chest drain
What treatment should be given for a secondary spontaneous pneumothorax 0-1cm in size with no associated symptoms?
Give oxygen and admit for 24 hours
What treatment should be given for a secondary spontaneous pneumothorax 1-2cm in size with no associated symptoms?
Aspiration and if this fails then do a chest drain
What treatment should be given for a secondary spontaneous pneumothorax greater than 2cm in size or with associated symptoms?
Chest drain
How is an aspiration performed?
A 16g cannula is inserted into the mid clavicular line of 2nd intercostal space
