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Open Pneumothorax
Aka: Open Pneumothorax, Sucking Chest Wound
- Pathophysiology
- Chest wall defect >2/3 tracheal diameter shunts air via chest defect instead of via trachea
- Results in a failure of respiratory dynamics and secondary Hypoxia and hypercarbia
- Symptoms
- History of Penetrating Trauma to chest
- See Pneumothorax
- Signs
- See Pneumothorax
- Large defect or Penetrating Trauma to chest wall
- Management
- Apply a sterile Occlusive Dressing to wound
- Tape dressing on 3 of the 4 sides (Valve effect)
- Offers only temporary stabilization until Chest Tube can be placed
- Chest Tube is the primary management for an open chest wound
- Do not completely occlude the wound until Chest Tube is in place (Tension Pneumothorax risk)
- Place Chest Tube remote from open wound
- Typical Chest Tube placement is over the 5th rib in the mid-axillary line
- Do not use the wound site for insertion of Chest Tube (contamination risk)
- Surgical Consultation
- Provides definitive chest wound closure
- References
- (2012) ATLS 9th ed, American College of Surgeons, Committee on Trauma, p. 96-9