ICU SAQs · Respiratory / ventilation
Tension pneumothorax and the chest drain
A CICM SAQ on tension pneumothorax — clinical diagnosis, needle decompression then a formal drain, triangle of safety, underwater seal, and not clamping a bubbling drain.
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Prompt
A ventilated patient develops sudden hypotension, a rising airway pressure, and absent breath sounds on the right side of the chest. Outline the diagnosis and the immediate management, including the chest drain technique.
Question
A ventilated patient develops sudden hypotension, a rising airway pressure, and absent breath sounds on the right side of the chest. Outline the diagnosis and the immediate management, including the chest drain technique.[2]
References5ShowHide
- [1]Harcke HT, Mabry RL, Mazuchowski EL Needle thoracentesis decompression: observations from postmortem computed tomography and autopsy J Spec Oper Med, 2013.PMID 24227562
- [2]de Lesquen H, Avaro JP, Gust L, et al Surgical management for the first 48 h following blunt chest trauma: state of the art (excluding vascular injuries) Interact Cardiovasc Thorac Surg, 2015.PMID 25476459
- [3]MacDuff A, Arnold A, Harvey J Management of spontaneous pneumothorax: British Thoracic Society Pleural Disease Guideline 2010 Thorax, 2010.PMID 20696690
- [4]Roberts ME, Rahman NM, Maskell NA, et al British Thoracic Society Guideline for pleural disease Thorax, 2023.PMID 37553157
- [5]Jones AL, Chah KT, Khoo WSM, et al Inserting With Care: Classification of Complications Related to Chest Drain Insertion Cureus, 2026.PMID 41798654