TENSION

PNEUMOTHORAX
Presented By: Ngo, Kayla Joy B.
BSN III - C
Description:

Tension pneumothorax is accumulation of air in the

pleural space under pressure, compressing the lungs
and decreasing venous return to the heart.
Signs and Symptoms:
Small pneumothoraces are occasionally asymptomatic.
Dyspnea
Pleuritic chest pain can stimulate:
Pericarditis
Pneumonia
Pleuritis
Pulmonary embolism
Musculoskeletal injury (when referred to the shoulder), or an intra-
abdominal process (when referred to the abdomen)
Pain can also simulate cardiac ischemia, although typically the pain of
cardiac ischemia is not pleuritic
Pathophysiology:

*Negative pressure- The negative pressure is required

to maintain lung inflation.
*Breach -When either pleura is breached, air enters
the pleural space.
*Collapse -When positive pressure has entered the
pleural space, the lung or a portion of it collapses.
Nursing Management
The nurse assesses tracheal alignment, expansion of the
chest, breath sounds, and percussion of the chest.

In a tension pneumothorax the trachea is shifted away from

the affected side.
Chest expansion may be decreased or fixed in a
hyperexpansion state.
Breath sounds are diminished or absent.
Percussion to the affected side is hyperresonant
Medical Management

Needle decompression followed by tube thoracostomy

Insert a large-bore (eg, 14- or 16-gauge) needle into the 2nd intercostal space in the midclavicular line.
Air will usually gush out. Because needle decompression causes a simple pneumothorax, tube thoracostomy
should be done immediately thereafter.
Diagnostic Management
Diagnosis of tension pneumothorax should be suspected in
individuals with respiratory distress, tracheal deviation,
distended neck veins, low blood pressure, and decreased or
absent breath sounds upon lung auscultation.

Clinical evaluation
Emergency treatment
Chest X-ray
Computerized tomography (CT)
SUMMARY