What happens during tension pneumothorax?
Tension pneumothorax occurs when air accumulates between the chest wall and the lung and increases pressure in the chest, reducing the amount of blood returned to the heart. Symptoms include chest pain, shortness of breath, rapid breathing, and a racing heart, followed by shock.
What shifts in tension pneumothorax?
In conventional pneumothorax, the heart is usually shifted toward the side of the thorax containing the most air, but in a tension pneumothorax the heart is shifted to the opposite side because of the increased pleural space pressure.
Can pneumothorax cause tension pneumothorax?
What causes tension pneumothorax? Tension pneumothorax can develop from any type of pneumothorax. However, it is most commonly seen after a traumatic chest injury or in individuals breathing through mechanical ventilation.
What is the most common cause of tension pneumothorax?
A pneumothorax can be caused by:
- Chest injury. Any blunt or penetrating injury to your chest can cause lung collapse.
- Lung disease. Damaged lung tissue is more likely to collapse.
- Ruptured air blisters. Small air blisters (blebs) can develop on the top of the lungs.
- Mechanical ventilation.
How do you identify tension pneumothorax?
Tension pneumothorax is classically characterized by hypotension and hypoxia. On examination, breath sounds are absent on the affected hemothorax and the trachea deviates away from the affected side. The thorax may also be hyperresonant; jugular venous distention and tachycardia may be present.
Which way does the trachea deviate in tension pneumothorax?
However, when tracheal deviation is present, the trachea will be displaced in the direction of less pressure. Meaning, that if one side of the chest cavity has an increase in pressure (such as in the case of a pneumothorax) the trachea will shift towards the opposing side.
What causes a tension pneumothorax?
Tension pneumothorax develops when a lung or chest wall injury is such that it allows air into the pleural space but not out of it (a one-way valve).
What opens pneumothorax?
An open pneumothorax occurs when a chest wall injury results in direct communication between the atmosphere and pleura. It is estimated that open pneumothorax occurs in 80% of all penetrating chest wounds, with stab wounds being more common than gunshot wounds or impalement.
How can you tell the difference between a tension pneumothorax and a hemothorax?
A hemothorax will have a similar presentation as a pneumothorax, with symptoms such as dyspnea, hypoxia, decreased breath sounds, and chest pain. A key clinical finding that separates these two is that a pneumothorax will have hyper-resonance to percussion, but a hemothorax will have a hypo-resonance to percussion.
What does tracheal shift indicate?
Tracheal deviation TOWARDS the lung problem This scenario occurs when the pressure in the lung and pleural cavity is less than the other side, and the trachea shifts toward the side with reduced pressure expanding it: Atelectasis. Pleural effusion. Apical lung fibrosis (for example, due to TB or prior radiotherapy)
Which assessment finding is commonly seen in a patient with a tension pneumothorax?
How do you handle tension pneumothorax?
Treatment of tension pneumothorax is immediate needle decompression by inserting a large-bore (eg, 14- or 16-gauge) needle into the 2nd intercostal space in the midclavicular line. Air will usually gush out.