Tension pneumothorax resident survival guide: Difference between revisions
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'''Focal chest examination'''<ref name="pmid20696690">{{cite journal| author=MacDuff A, Arnold A, Harvey J, BTS Pleural Disease Guideline Group| title=Management of spontaneous pneumothorax: British Thoracic Society Pleural Disease Guideline 2010. | journal=Thorax | year= 2010 | volume= 65 Suppl 2 | issue= | pages= ii18-31 | pmid=20696690 | doi=10.1136/thx.2010.136986 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20696690 }} </ref><BR> | '''Focal chest examination'''<ref name="pmid20696690">{{cite journal| author=MacDuff A, Arnold A, Harvey J, BTS Pleural Disease Guideline Group| title=Management of spontaneous pneumothorax: British Thoracic Society Pleural Disease Guideline 2010. | journal=Thorax | year= 2010 | volume= 65 Suppl 2 | issue= | pages= ii18-31 | pmid=20696690 | doi=10.1136/thx.2010.136986 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20696690 }} </ref><BR> | ||
'''Inspection'''<BR> | |||
❑ Reduced lung expansion on the affected side <BR> | ❑ Reduced lung expansion on the affected side <BR> | ||
❑ Enlarged involved hemithorax<BR> | ❑ Enlarged involved hemithorax<BR> | ||
❑ Jugular venous distension<BR> | |||
'''Palpation'''<BR> | |||
❑ Trachea shifted to the opposite side<BR> | ❑ Trachea shifted to the opposite side<BR> | ||
❑ Decreased tactile vocal fremitus<BR> | |||
'''Percussion'''<BR> | |||
❑ Hyper-resonance<BR> | ❑ Hyper-resonance<BR> | ||
'''Auscultation'''<BR> | |||
❑ Diminished breath sounds on the affected side<BR> | ❑ Diminished breath sounds on the affected side<BR> | ||
Revision as of 18:15, 11 March 2014
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
- Mechanical ventilation
- Blunt trauma
- Central venous catheter
- Cardiopulmonary resuscitation
- Emphysema
- Chronic obstructive pulmonary disease
- Asthma
Management
Shown below is an algorithm depicting the management of tension pneumothorax.
Characterize the symptoms:[1] ❑ Breathlessness | |||||||||||||
Examine the patient: Vital signs ❑ Respiratory rate:
❑ Heart rate: ❑ Blood pressure Focal chest examination[1] Inspection ❑ Reduced lung expansion on the affected side Palpation ❑ Trachea shifted to the opposite side Percussion ❑ Hyper-resonance Auscultation ❑ Diminished breath sounds on the affected side | |||||||||||||
References
- ↑ 1.0 1.1 MacDuff A, Arnold A, Harvey J, BTS Pleural Disease Guideline Group (2010). "Management of spontaneous pneumothorax: British Thoracic Society Pleural Disease Guideline 2010". Thorax. 65 Suppl 2: ii18–31. doi:10.1136/thx.2010.136986. PMID 20696690.