In this latest video from MedCram, Dr. Seheult delves into what a pneumothorax is and how to manage it with a chest tube. A pneumothorax is a critical medical condition that can escalate into life-threatening situations if not properly managed. A pneumothorax refers to the presence of air in the pleural cavity (the space between the lungs and the chest wall), which can cause the lung to collapse. This can occur spontaneously or due to trauma, such as rib fractures or lung injury. There are different classes of pneumothorax including spontaneous, primary or secondary pneumothorax. For more of an in depth study please see MedCram’s Pneumothorax and Chest Tube Management CME course.
Why is a pneumothorax dangerous?
If the lungs collapse they will not be exchanging as much air and the patient is going to be in respiratory distress. However a more severe complication of pneumothorax is something called a tension pneumothorax. In a tension pneumothorax, the air that comes in with every breath is escaping from the lungs into the pleural cavity and has nowhere to go. The pressure inside the cavity as a result builds up and starts to put pressure on the heart. When this happens to the heart, blood can’t flow into it and as a result the heart will eventually shut down leading to cardiac arrest. On an x-ray you can see tracheal deviation as well. This is treated with a chest tube that allows release of the built up air and reexpansion of the lung. You can also use ultrasound to evaluate for pneumothorax as well. MedCram also has a course on Ultrasound Principles and Instrumentation.
A pneumothorax can present in different ways in patients, from sudden chest pain and shortness of breath to more subtle symptoms like a decrease in oxygen saturation or changes in breath sounds.
What is a chest tube?
Chest tubes are what are used to treat a pneumothorax. A chest tube is a sterile, flexible tube inserted into the pleural space through a small incision in the chest. It is connected to a suction device or water-seal drainage system that helps evacuate air or fluid from the pleural cavity. The first container is where the collection occurs. The next container is a water seal and the last container is a suction control. If you see ongoing bubbles in the water seal container this is suggestive of an air leak. If you ever have to transport a patient who is hospitalized and has an air leak, be sure to hook them up to portable suction prior to transportation as it would be dangerous otherwise. For further details please be sure to refer to MedCram’s newest series on Pneumothorax and Chest Tube Management.
LINKS / REFERENCES:
Pneumothorax and Chest Tubes Explained Clearly (MedCram) | https://www.medcram.com/courses/pneum…