Tension Pneumothorax Vs Pneumothorax

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Tension pneumothorax

vs
Pneumothorax
This occurs when there is a communication between the
lung and the pleural space, with a flap of tissue
acting as a valve, allowing air to enter the pleural space
during inspiration and preventing it from leaving
during expiration.

A tension pneumothorax results from air accumulating


under increasing pressure in the pleural space.

Causes:
● Trauma.
● Mechanical ventilation at high pressure
Pneumothorax Tension pneumothorax

Primary spontaneous pneumothoraces: A medical emergency that requires immediate


Young people without known respiratory intervention to decompress the involved
illnesses hemithorax.

Secondary spontaneous pneumothoraces: Increasing trapped air increases tension


Patients with pre-existing pulmonary diseases pneumothorax.

May lead to increased intrathoracic pressure,


leading to reduced venous return and cardiac
function

Dyspnoea Rapid laboured respirations


Chest pain Cyanosis
Uneven chest pain Profuse diaphoresis
Tachycardia

● Observation with supplemental oxygen


therapy
● Percutaneous aspiration of the air in the
pleural space
● Chest-tube thoracostomy
● Video-assisted thoracoscopy or
thoracostomy in some cases
Expansion: reduced or absent on affected side
Vocal resonance: absent
Hemothorax
A collection of blood in the the pleural cavity.

Hemothorax results more commonly from injury to a major intercostal or internal thoracic vessel than from laceration of a lung

Injuries leading to massive hemothorax include:

● Aortic rupture
● Myocardial rupture
● Injuries to hilar structures, lung parenchyma, intercostal or mammary blood vessels

Hemothorax is treated with:

● Tube thoracostomy using a large (minimum 36 French) chest tube


○ Immediate bloody drainage of ≥20 mL/kg (approximately 1500 mL) is generally considered an indication for surgical
thoracotomy

Shock and persistent, substantial bleeding (generally >3 mL/kg/hour) are additional indications.

Vital signs, fluid resuscitation requirements, and concomitant injuries are considered when determining the need for thoracotomy.

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