PNEUMOTHORAX

Question 1

Define pneumothorax.

Answer 1

Abnormal collection of air in the pleural space.

Question 2

What are the causes of a spontaneous pneumothorax?

Answer 2

Rupture of sub-pleural bulla
Asthma
COPD - emphysema
TB
Pneumonia
Lung abscess
Carcinoma
Cystic fibrosis
Lung fibrosis
Sarcoidosis
Marfan's syndrome
Ehlers-Danlos syndrome
Mechanically ventilated patients

Question 3

How might someone with a suspected pneumothorax present? (Name 3 symptoms)

Answer 3

Sudden onset dyspnoea 
Pleuritic chest pain
Sudden deterioration in asthma or COPD patients
Trauma (such as a stab wound)
Hypotension
Raised JVP

Question 4

On examination, what might you find in someone with a suspected pneumothorax?

Answer 4

Reduced expansion
Hyper-resonance to percussion
Diminished breath sounds
Tracheal deviation
Tachycardia

Question 5

What is the management protocol for someone with a suspected tension pneumothorax?

Answer 5

Insert large bore (14-16G) needle with syringe, partially filled with 0.9% saline, into 2nd intercostal space in midclavicular line on the side of the suspected pneumothorax.
DO NOT DO CHEST X RAY UNTIL ASPIRATED
Then insert chest drain into 5th intercostal space, mid axillary line.