EMERGENCY MEDICINE BLOCK

PNEUMOTHORAX

Ronald Chrisbianto Gani

405090223
Faculty of Medicine
Tarumanagara University

PNEUMOTHORAX

PNEUMOTHORAX
Accumulation of air in the pleural
space
Reported to be present in 15-50%
traumatic patients
Classified as :
Simple
Communicating
Tension
Simple Pneumothorax

Rosens Emergency Medicine 7th E

COMMUNICATING PNEUMOTHORAX

Rosens Emergency Medicine 7th E

TENSION PNEUMOTHORAX

Tension Pneumothorax

After Tube Throacostomy

Rosens Emergency Medicine 7th E

CLINICAL FEATURES
Signs : dyspneic, agitated, restless,
cyanotic, tachycardic, hypotensive,
decreased mental activity, jugular
vein distension
Symptoms : Shortness of breath,
Chest pain
PE : decreased/absent breath sound,
hyperresonance

Rosens Emergency Medicine 7th E

DIAGNOSIS
Initial chest radiography while full
inspiration
Focused Assesment with Sonography
for Trauma (FAST) examination
CT-Scan
Occult Pneumothorax
PTX that is absent on initial CXR but
present i subsequent chest or
abdominal CT-Scan

Rosens Emergency Medicine 7th E

OCCULT PNEUMOTHORAX

Rosens Emergency Medicine 7th E

MANAGEMENT

Asymptomatic & Negative CXR

observe for 3 hours, or 6hours for
blunt trauma
Simple Pneumothorax chest tube
in 4th or 5th intercostal space at the
anterior or midaxilarry site (36-40F
adults, 16-32F child)
Complications of chest tube :
hemothorax, pulmonary edema,
bronchopleural fistula, pleural
leaks,
Rosens Emergency Medicine 7th E

MANAGEMENT
Communicating Pneumothorax
defect should be covered. In ED
ETT & Chest Tube + Surgical repair
Tension Pneumothorax needle
thoracostomy throung 2nd or 3rd
interspace anterior or 4th or 5th
interspace lateral

Rosens Emergency Medicine 7th E

TUBE THORACOSTOMY

Rosens Emergency Medicine 7th E