Tension Pneumothorax

Question 1

ESSENCE

Answer 1

Caused by trauma to chest wall that creates one-way valve, letting air into pleural space but not out, air goes in during inspiration

Creats pressure inside thorax and moves mediastinum across, kinking major blood vessels

Question 2

CLINICAL FEATURES

Signs

Answer 2

• Tracheal deviation away from side of pneumothorax
• Reduced air entry on affected side
• Increased resonance to percussion on affected side
• Tachycardia
• Hypotension

Question 3

MANAGEMENT

General

Answer 3

• Insert large bore cannula into second intercostal space in midclavicular line
  
  • Then insert chest drain for definitive management
• Do not wait for investigations