Created by Aaron Samide
over 8 years ago
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Question | Answer |
2-year recurrence rate of spontaneous pneumothorax | 50% |
Symptoms associated with pneumothorax (3) | - Sudden, ipsilateral chest pain - Dyspnea - Cough |
Physical signs of pneumothorax (4) | - Decreased breath sounds on affected side - Hyperresonance - Decreased/absent tactile fremitus - Mediastinal shift towards affected side |
Treatment of primary spontaneous pneumothorax if small & asymptomatic | Observation |
Treatment of primary spontaneous PTX if larger and/or symptomatic | Supplemental oxygen Needle aspiration or chest tube insertion |
Treatment of secondary spontaneous pneumothorax (complication of underlying lung disease) | Chest tube drainage (more life-threatening because of decreased pulmonary reserve in these patients at baseline) |
General pathophysiology of tension pneumothorax | Accumulation of air within pleural space --> tissues surrounding the opening into pleural cavity act as valves, allowing air to enter but not escape Resultant positive pressure in pleural space collapses the ipsilateral lung & shifts mediastinum away from that side |
3 causes of tension pneumothorax | - Mechanical ventilation (barotrauma) - CPR - Trauma |
Clinical features of tension pneumothorax (5) | - Hypotension (impaired cardiac filling) - Distended neck veins - Tracheal shift to other side - Decreased breath sounds on affected side - Hyperresonance to percussion on affected side |
T/F: A CXR should be obtained first if tension pneumothorax is suspected | False; immediately decompress the pleural space w/ large-bore needle or chest tube! |
Where should the large-bore needle be placed to decompress the chest in the case of a tension PTX? | 2nd or 3rd intercostal space in mid-clavicular line |
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