Chest Injuries Intermediate

Pneumothorax Is a condition that results from air entering the interpleural space The air in the interpleural space compresses the lung and prevents normal breathing There are two types of pneumothorax: Tension pneumothorax Spontaneous pneumothorax A pneumothorax is a condition that results from air entering the interpleural space. The air in the interpleural space compresses the lung and prevents normal breathing. There are two types of pneumothorax: • tension pneumothorax, and • spontaneous pneumothorax Tension pneumothorax is particularly dangerous. It is a condition that occurs when air escapes into the interpleural space from damaged lung tissue but cannot regain entry into the lungs with each respiration. As a result, increasing air pressure in the interpleural space causes collapse of the lung tissue. As the pneumothorax injured lung collapses, the opposite lung and heart may also be affected. Tension pneumothorax: Happens as result of traumatic injury OR A progression or complication of spontaneous pneumothorax that does not heal on it’s own Can be life-threatening as air moves from lung into interpleural space. It can’t go back into the lung. Results in increased pressure resulting in the lung collapsing and may start pushing on the other lung or heart Spontaneous pneumothorax is not a life-threatening condition. It occurs when the lung surface - weakened as a result of congenital defect, disease or injury - ruptures. Spontaneous pneumothorax: Occur in the absence of traumatic injury Usually happen as a result of underlying lung disease May resolve itself if it is small Is not as life-threatening

Pneumothorax Signs and symptoms Reduction of normal respiratory movements on the affected side A fall in blood pressure Weak and rapid pulse A sudden sharp chest pain Signs and symptoms of a pneumothorax include: • reduction of normal respiratory movements on the affected side, • a fall in blood pressure, • weak and rapid pulse, and • a sudden sharp chest pain.

Pneumothorax Treatment for Tension Pneumothorax Give oxygen Activate EMS and treat as Load and Go Continue to monitor vital signs Treatment for Spontaneous Pneumothorax Transport to medical aid The patient may prefer to be transported sitting up Treatment for a tension pneumothorax is Administer oxygen, if available, Activate EMS and treat as a load and go. Monitor vital signs. As a first aid provider, you cannot provide surgical release of the air from the chest cavity. The treatment for a spontaneous pneumothorax is: Administer oxygen, if available. Transport patient to medical aid The patient may prefer to be in a seated position when being transported.

Subcutaneous Emphysema When a lung or part of bronchi is lacerated, air can escape into the chest cavity Can migrate to subcutaneous tissues Feels like Rice Krispies under the skin – like a crackling sensation when pressed When a lung or part of the bronchi is lacerated, air can escape into the chest cavity. This air can then migrate to the subcutaneous tissues making it feel like puffed rice (Rice Krispies) under the skin. This causes a crackling sensation when the skin is pressed. This is why you looked for it during the secondary assessment.