How do you differentiate a tension pneumothorax from a simple pneumothorax?

Pneumothoraces can be even further classified as simple, tension, or open. A simple pneumothorax does not shift the mediastinal structures, as does a tension pneumothorax. An open pneumothorax also is known as a “sucking” chest wound.

How does a pneumothorax become a tension pneumothorax?

A tension pneumothorax occurs when the patient cannot compensate, and several events begin to occur that can lead to death. As air fills the pleural space on inspiration through the opening with an open pneumothorax, the wound can act as a one-way valve and not allow the air to exit.

What is tension pneumothorax?

A tension pneumothorax is a life-threatening condition that develops when air is trapped in the pleural cavity under positive pressure, displacing mediastinal structures and compromising cardiopulmonary function. Prompt recognition of this condition is life saving, both outside the hospital and in a modern ICU.

Why is there hypotension in tension pneumothorax?

However, in tension pneumothorax, air continues to enter the pleural space as the person breathes and pressure rises inside the chest. The rise in pressure reduces the amount of blood returning from the body to the heart because the blood cannot force its way into the chest and back to the heart.

How is a tension pneumothorax diagnosed?

A pneumothorax is generally diagnosed using a chest X-ray. In some cases, a computerized tomography (CT) scan may be needed to provide more-detailed images. Ultrasound imaging also may be used to identify a pneumothorax.

How do you identify a tension pneumothorax?

Tension pneumothorax is classically characterized by hypotension and hypoxia. On examination, breath sounds are absent on the affected hemothorax and the trachea deviates away from the affected side. The thorax may also be hyperresonant; jugular venous distention and tachycardia may be present.

What is the difference between a pneumothorax and atelectasis?

A collapsed lung happens when air enters the pleural space, the area between the lung and the chest wall. If it is a total collapse, it is called pneumothorax. If only part of the lung is affected, it is called atelectasis.

How is a tension pneumothorax treated?

Treatment of tension pneumothorax is immediate needle decompression by inserting a large-bore (eg, 14- or 16-gauge) needle into the 2nd intercostal space in the midclavicular line. Air will usually gush out.

What is the difference between pneumothorax and hemothorax?

Pneumothorax, which is also known as a collapsed lung, happens when there is air outside the lung, in the space between the lung and the chest cavity. Hemothorax occurs when there is blood in that same space.

Is a tension pneumothorax a collapsed lung?

A pneumothorax (noo-moe-THOR-aks) is a collapsed lung. A pneumothorax occurs when air leaks into the space between your lung and chest wall. This air pushes on the outside of your lung and makes it collapse. A pneumothorax can be a complete lung collapse or a collapse of only a portion of the lung.

What is a tension hemothorax?

A tension hemothorax refers to a hemothorax that exerts a considerable mass effect. It often results from massive intrathoracic hemorrhage and often causes ipsilateral lung compression and mediastinal displacement.