When does open pneumothorax develop?
- Open pneumothorax develops as a result of a large open defect in the chest (“sucking chest wound” ) leading to equilibration between intrathoracic and atmospheric pressure.
- Air accumulates in the hemithorax with each inspiration leading to profound hypoventilation and hypoxia.
What is the treatment of open pneumothorax during the primary survey?
The treatment of the open pneumothorax during primary survey is:
Aimed: at returning normal ventilation and closing the chest wound.
- The first step is placing an occlusive dressing over the chest wound to promote normal ventilation.
- A standard method involves placing a nonporous dressing over the wound and taping it on 3 sides.
- This acts as a 1-way valve allowing air to escape during expiration but becomes occlusive during inspiration.
What is the clinical presentation of open pneumothorax?
Clinical examination in patients with open pneumothorax can establish:
- Visible chest wall defect
- Dyspnea
- Tachypnea
- Cyanosis'
- Asymmetrical chest expansion
- Hypotonia
- Decreased (↓) breath sounds on the side of the injury.