This occurs when air enters the plural space, causing lung collapse on the affected side.
- Spontaneous development following staphylococcal pneumonia due to chronic obstructive pulmonary disease.
- Rib fractures and or lung contusion
- Penetrating injuries
- Stab wounds, and missiles.
- There is shortness of breath
- Tightness of the affected chest
- Tachypnoea, and tachycardia.
- Sweating and cyanosis may be present.
- Reduced chest excursion also occurs, with reduced air entry on auscultation.
- Hyper-resonant chest is noted on percussion.
- Chest radiograph: Shows various degrees of lung collapse.
- If more than 5% pneumothorax, institute tube thoracostomy drainage (underwater seal drainage); maintain absolute sterility while performing the procedure.
- Chest tube may be removed when the lung is fully expanded and remains fully expanded after test clamping the chest tube for a number of hours.
- Tension pneumothorax needs more rapid treatment with immediate insertion of a wide bore cannula drainage or underwater seal drainage under local anaesthesia.
- Tension pneumothorax is a clinical diagnosis and not a radiological diagnosis. Ordering a chest radiograph may result in patient death before active treatment can be implemented.
- An associated frail chest leads to paradoxical breathing and may require assisted ventilation (i.e., intermittent positive pressure ventilation), if features of respiratory failure develop