When does a pneumothorax occur?
Occurs when air accumulates in the pleural space.
What causes a tension pneumothorax?
If air enters the pleural space and cannot escape.
True or False…
A tension pneumothorax is a medical emergency.
True.
What is a pneumothorax often related to?
- Trauma
- Medical intervention (iatrogenic)
How does primary spontaneous pneumothorax occur without?
Without any trauma or known respiratory illness.
How does secondary spontaneous pneumonia occur?
Known respiratory illness.
What are the S&S of a pneumothorax?
- Unilateral chest pain
- Absent breath sounds on auscultation over collapsed lung
- Increased HR
- Increased RR
- Shortness of breath (SOB)
- Cyanosis (i.e. blue lips, nails, skin)
- Reduced chest wall movement on side of collapsed lung
- Excessive sweating (tends to be tension pneumothorax)
- May have CV instability as pneumothorax progresses
What are risk factors for pneumothorax?
- Known chronic lung disease (e.g. COPD, cystic fibrosis, pulmonary fibrosis)
- Trauma (e.g. Renal Tubular Acidosis (RTA), gunshot wound, stab wound)
- Mechanical ventilation
- Flying
- Scuba diving
- Inhaling drugs
- Smoking
- Marfan’s syndrome
- Tall, thin, male
- Pregnancy
- Family history or previous pneumothorax
What are treatments for pneumothorax?
- Minor (May just watch and wait for it to resolve)
- Oxygen therapy
- Thoracentesis
- Chest drain
- Pleurodesis
What is thoracentesis as a treatment for pneumothorax?
Fine needle between ribs to decompress air
(For a smaller pneumothorax).
How is a chest drain used as treatment for pneumothorax?
Tube placed into pleural space, usually left for a few days until lung has re-expanded.
(For bigger pneumothorax).
How is pleurodesis used as a treatment for pneumothorax?
- Chemical or surgical, sticks lung to chest cavity.
- Makes any future lung surgery more difficult (e.g. lung transplant)
What treatments can physios use for a pneumothorax?
- Oxygen therapy.
- Breathlessness management.
- Avoid positive pressure until pneumothorax has been drained or is draining.
- Pain management.
- Supported cough.
- Airway clearance techniques (especially important in chronic lung disease).
- Mobilising (will prevent secondary complications such as DVT).
What is pneumothorax?
Accumulation of air in the pleural space.
Why does pneumothorax occur?
- Traumatic (e.g. penetrating chest wall injury)
- Spontaneous
- Due to underlying lung disease
What does tension pneumothorax cause?
- Mediastinal shift
- Significant pulmonary & cardiovascular compromise
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Pulmonary Pathologies (General)6
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Sputum9
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Symptoms2
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Obstructive Lung Disorders4
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Restrictive Lung Disorders3
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Asthma2
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Atelectasis2
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Breathlessness9
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Bronchiectasis3
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Consolidation1
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COPD19
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COPD Exacerbation10
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Empyema1
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Pleural Effusion5
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Pneumonia14
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Pneumothorax16
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Pulmonary Embolism3
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Pulmonary Oedema6
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Respiratory Failure23
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Respiratory Tract Infections1
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Tracheomalacia1
