Pneumothorax

Question 1

What is a pneumothorax?

Answer 1

air in the pleural space

Question 2

how could pneumothoraxes occur?

Answer 2

1) spontaneously

2) as a result of trauma

Question 3

who is at a greater risk of getting a pneumothorax?

Answer 3

• tall, thin people
• males
• smokers
• cannabis users
• people with underlying lung disease

Question 4

what are the symptoms of a pneumothorax?

Answer 4

1) chest pain
- usually of a sudden onset

2) pain is SHARP
- feeling of tightness

3) shortness of breath
4) rapid heart rate
5) rapid breathing
6) cough
7) fatigue

Question 5

what would you find on examination of a pneumothorax?

Answer 5

1) hyper-resonant percussion note
2) reduced expansion
3) reduced expansion
4) quiet breath sounds on auscultation

Question 6

what are the different types of pneumothorax?

Answer 6

1) primary spontaneous pneumothorax
2) secondary pneumothorax
3) tension pneumothorax

Question 7

what is a primary pneumothorax?

Answer 7

• likely due to the formation of small sacs of air in lung tissue that rupture causing air to leak into the pleural soaked
• not caused by an injury or trauma its spontaneous

Question 8

what is a secondary pneumothorax?

What factors increase your risk of getting a secondary penumothorax?

Answer 8

pneumothorax that occurs as a complication of an underlying disease

• COPD
• asthma

Question 9

what is a tension pneumothorax?

Answer 9

• a progressive build up of air within the pleural space
• air escapes into the pleural space but cannot return causing a positive pressure ventilation
  = an emergency

Question 10

how would you investigate a pneumothorax?

Answer 10

• chest X-ray is usually sufficient

- or a CT scan

Question 11

how would you manage a primary spontaneous pneumothorax that is < 2cm?

Answer 11

1) high flow oxygen

Question 12

how would manage a primary spontaneous pneumothorax that is > 2cm>

Answer 12

1) high flow oxygen
2) aspirate air
3) if aspiration fails to improve the patients condition then perform a chest drain

Question 13

what are the symptoms of a tension pneumothorax?

Answer 13

1) tracheal deviation
2) hypotension
3) raised JVP
4) reduced air entry on affected side

Question 14

how would you treat a tension pneumothorax?

Answer 14

1) needle decompression

- done so by second intercostal space anteriorly, mid clavicular line