Pneumothorax due to air escaping into the pleural cavity, typically as a
consequence of a penetrating injury. The increasing air pressure in the pleural
cavity progressively collapses the lung. Intrapleural pressure can increase to
the point where it interferes with venous return, resulting in blood pooling in
capacitance vessels, with ensuing cardiovascular collapse and shock.
- Muffled heart sounds
- Muffled lung sounds
- Respiratory distress
- Tachypnoea (rapid shallow respiration)
- A monitor rhythm, but no pulse (similar to PEA).
- Deviation of trachea away from tension side
- Hyper-expanded chest
Treatment of tension pneumothorax is to alleviate the increased intrapleural
pressure, by performing thoracocentesis with a 20g needle in the 7th or 8th
intercostal space. If pneumothorax recurs, a tube thoracostomy may be performed.