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In contrast, tension pneumothorax is a medical emergency and may be treated before imaging – especially if there is severe hypoxia, very low blood pressure, or an impaired level of consciousness. In tension pneumothorax, X-rays are sometimes required if there is doubt about the anatomical location of the pneumothorax. [16] [18]
Left-sided tension pneumothorax. Note the area without lung markings which is air in the pleural space. Also note the tracheal and mediastinal shift from the patient's left to right. Causes include any obstruction of blood flow to and from the heart. There are multiple, including pulmonary embolism, cardiac tamponade, and tension pneumothorax.
Image shows early occurrence of tracheal deviation. Tracheal deviation is a clinical sign that results from unequal intrathoracic pressure within the chest cavity.It is most commonly associated with traumatic pneumothorax, but can be caused by a number of both acute and chronic health issues, such as pneumonectomy, atelectasis, pleural effusion, fibrothorax (pleural fibrosis), or some cancers ...
Tension pneumothorax is an emergent condition in which air gets trapped in the space between the chest wall and the lung. This space is referred to as the pleural space. Because air can't escape from this space, the air pocket grows larger and larger, resulting in the lung collapse closest to the pneumothorax.
Therefore, pneumothorax is usually more of a problem than hemothorax. [8] A pneumothorax may form or be turned into a tension pneumothorax by mechanical ventilation, which may force air out of the tear in the lung. [12] The laceration may also close up by itself, which can cause it to trap blood and potentially form a cyst or hematoma. [8]
Signs of serious chest injuries, including penetrating trauma to the chest, which can cause a sucking chest wound; flail chest; tension pneumothorax; and cardiac tamponade; Breathing problems (like airway problems, these are also rechecked during the rapid trauma assessment by listening to breath sounds with a stethoscope)
In the emergency department the typical approach to chest pain involves ruling out the most dangerous causes: heart attack, pulmonary embolism, thoracic aortic dissection, esophageal rupture, tension pneumothorax, and cardiac tamponade. By elimination or confirmation of the most serious causes, a diagnosis of the origin of the pain may be made.
Tension pneumothorax is the build-up of air into one of the pleural cavities, which causes a mediastinal shift. When this happens, the great vessels (particularly the superior vena cava ) become kinked, which limits blood return to the heart .