Tension pneumothorax resident survival guide

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Tension pneumothorax is a medical emergency caused by accumulation of air in the pleural cavity. Air enter the intrapleural space through the lung parenchyma, or through a traumatic communication from the chest wall.

Causes

Life Threatening Causes

Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated. Tension pneumothorax is a life-threatening condition and must be treated as such irrespective of the underlying causes.

Common Causes

Management

Shown below is an algorithm depicting the management of tension pneumothorax.

Characterize the symptoms:

Breathlessness
Chest pain
Cyanosis
Sweating
Anxiety
Fatigue

 
 
 
 
 
 
 
 
 
 
 
 
Identify existing risk factors:


 
 
 
 
 
 
 
 
 
 
 
Examine the patient:

Vital signs

❑ Sever tachypnea
Tachycardia
Hypotension

Focal chest examination

❑ Reduced lung expansion on the affected side
❑ Enlarged involved hemithorax
❑ Trachea shifted to the opposite side
❑ Hyper-resonance
❑ Decreased tactile vocal fremitus
❑ Jugular venous distension
❑ Diminished breath sounds on the affected side

 
 
 
 

References


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