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Pneumothorax
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Pneumothorax
See Also
Blunt Chest Trauma
Types
Spontaneous Pneumothorax
(
Simple Pneumothorax
)
Open Pneumothorax
Tension Pneumothorax
Hemothorax
Pathophysiology
Air enters potential space between the visceral pleura and the parietal pleura
Tension Pneumothorax
may result
Air accumulates in the pleural space with each breath taken
Pressure compresses the lung tissue and inhibits venous return with secondary decreased
Cardiac Output
Causes
Adults
Blunt Chest Trauma
Most common cause of sports-related Pneumothorax
Consider other concurrent injuries (e.g.
Pulmonary Contusion
)
Penetrating
Chest Trauma
Spontaneous Pneumothorax
Iatrogenic Pneumothorax (secondary to medical procedure)
Risk Factors
Newborns (1-3% of births)
Premature Infant
Respiratory distress syndrome
Meconium Aspiration Syndrome
Signs
Decreased breath sounds
Hyperresonance to percussion
Imaging
Chest XRay
See
Pneumothorax Imaging
Upright and end expiratory films are preferred
Supine
Chest XRay
is unreliable and likely to yield a
False Negative
study
Ultrasound
See
Lung Ultrasound for Pneumothorax
(
Sliding Lung Sign
)
Part of
Extended FAST Exam
Precautions
Until a
Chest Tube
is placed,
Tension Pneumothorax
is a risk
Do not perform
Positive Pressure Ventilation
, general
Anesthesia
or air transport until Pneumothorax decompression
Consider
Esophageal Rupture
in the injured patient with a left Pneumothorax or
Hemothorax
without a
Rib Fracture
Management
See
Spontaneous Pneumothorax
(includes disposition and restrictions)
See
Tension Pneumothorax
See
Open Pneumothorax
See
Hemothorax
Non-
Trauma
tic Pneumothorax
See
Spontaneous Pneumothorax
Trauma
tic Pneumothorax
Chest Tube
at 4-5th intercostal space at the mid-axillary line
Confirm
Chest Tube
placement with
Chest XRay
Outside of
Hemothorax
(and hemopneumothorax),
Small Caliber Chest Tube
s appear safe in uncomplicated
Trauma
tic Pneumothorax
Small Caliber Chest Tube
s are as effective and significantly less painful than standard
Chest Tube
s in Pneumothorax
Kulvatunyou (2014) Br J Surg 101(2): 17-22 [PubMed]
Complications
Tension Pneumothorax
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