Tension pneumothorax resident survival guide: Difference between revisions

Revision as of 18:04, 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

Management

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

Characterize the symptoms:^[1]

❑ Breathlessness
❑ Chest pain
❑ Cyanosis
❑ Sweating
❑ Anxiety
❑ Fatigue

Identify existing risk factors:

❑

Examine the patient:

Vital signs

❑ Respiratory rate:

❑ Sever tachypnea

❑ Heart rate:

❑ Tachycardia

❑ Blood pressure

❑ Hypotension

Focal chest examination^[1]

❑ 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

↑ ^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.

Template:WikiDoc Sources

[pmid20696690-1] 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.

[1]

@@ Line 42: / Line 42: @@
 '''Vital signs'''<BR>
-❑ Sever [[tachypnea]]<BR>
+❑ Respiratory rate:<BR>
-❑ [[Tachycardia]]<BR>
+:❑ Sever [[tachypnea]]<BR>
-❑ [[Hypotension]] <BR>
+❑ Heart rate:<BR>
+:❑ [[Tachycardia]]<BR>
+❑ Blood pressure<BR>
+:❑ [[Hypotension]] <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>