On pathophysiological point of view, traumatic pneumothorax is divided in 3 subtypes. Which are they? Which is the most severe type?
On pathophysiological point of view, traumatic pneumothorax is divided in:
- Simple
- Open
- Tension: Tension pneumothorax is the most severe type.
When does tension pneumothorax develop?
- A tension pneumothorax develops when a ‘one way valve’ air leak occurs, either from the lung or through the chest wall.
- Air is forced into the thoracic cavity without any means of escape, completely collapsing the affected lung.
- The mediastinum gets displaced to the opposite side decreasing venous return and compressing the opposite lung.
What is the definition of “simple pneumothorax”?
- Simple pneumothorax is defined as a collection of air trapped in the pleural space.
What is the treatment of the tension pneumothorax during primary survey?
Treatment Aimed: at decompressing the chest to release the trapped air from the pleural cavity
- Convert tension into open pneumothorax.
- After that try to place a nonporous dressing over the wound and taping it onto 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 tension pneumothorax?
The clinical presentation of tension pneumothorax is dramatic.
- The patient is panicky with tachypnoea, dyspnea & distended neck veins (Similar to pericardial tamponade).
- Clinical examination can reveal tracheal deviation, hyper resonance & absent breath sounds over the affected hemithorax.