PNEUMOTHORAX

 

TENSION PNEUMOTHORAX

 

 

Tension Pneumothorax is usually the result of blunt chest trauma in which a damaged area of lung tissue does not seal itself off. The tension pneumothorax itself is caused by air leaking into the pleural space through a hole in the lung which acts as a one-way valve (See above). Air enters the pleural space during inhalation but cannot escape during exhalation, so air builds up in the affected pleural cavity. As the pressure in the affected side increases, it pushes the Mediastinum (space the heart sits in), in the opposite direction ( as evidenced by tracheal deviation away from the side of the Pneumothorax), squeezing the opposite lung and thereby compromising it’s ventilation as well. Also, as the mediastinum is pushed away from the tension Pneumothorax, the superior and inferior venae cavae become kinked and compressed, which in turn hinders the return of blood to the right side of the heart. As a result, cardiac output falls and backs up in the systemic veins.

 

 

 

 

 

TENSION PNEUMOTHORAX

 

SIGNS AND SYMPTOMS

 

Extreme Dyspnoea (severe difficulty breathing)

 

Rapid and weak pulse

 

Marked distension of the Jugular veins

 

Diminished breath sounds on the affected side

 

Restlessness and Anxiety

 

Hyperresonance to percussion on the affected side

 

In some instances, cutaneous emphysema is present in the chest and neck, to give a grotesque and bloated appearance.

 

 

TREATMENT

 

A B C

 

Seal off any chest wounds

 

Give high concentration of oxygen

 

Recline patient on affected side (to let good lung work)

 

Place on heart monitor, be prepared to commence CPR

 

Remove patient to casualty as quickly and smoothly as possible.

 

Inform receiving casualty by radio of condition of patient you are bringing in.