Pneumothorax (including tension pneumothorax)

Your progress

Saved on this device.

Target exams

Red flags

• Tension pneumothorax is a CLINICAL diagnosis — hypotension, hypoxia, distended neck veins and absent breath sounds on one side — decompress immediately, do NOT wait for a chest radiograph
• Decompress at the 5th intercostal space, anterior to mid-axillary line, with a device long enough to reach the pleura — the chest wall is often thicker than a standard intravenous cannula
• A sudden deterioration with rising airway pressure and hypotension in a ventilated patient is a tension pneumothorax until proven otherwise
• A giant bulla can mimic a pneumothorax on a chest radiograph — confirm with CT before draining, or you create a bronchopleural fistula
• Rapid re-expansion of a large, long-standing pneumothorax causes re-expansion pulmonary oedema — drain incrementally