Ronald Chrisbianto Gani

405090223
Faculty of Medicine
Tarumanagara University
EMERGENCY MEDICINE BLOCK
PNEUMOTHORAX
PNEUMOTHORAX
PNEUMOTHORAX
Accumulation of air in the pleural space
Reported to be present in 15-50% traumatic
patients
Classified as :
Simple
Communicating
Tension
Rosens Emergency Medicine 7th Ed
Simple Pneumothorax
COMMUNICATING PNEUMOTHORAX
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TENSION PNEUMOTHORAX
Tension Pneumothorax After Tube Throacostomy
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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
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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
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OCCULT PNEUMOTHORAX
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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, empyema, infection, etc
Rosens Emergency Medicine 7th Ed
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
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TUBE THORACOSTOMY
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