What Can Be Done For A Collapsed Lung – A pneumothorax, also known as a collapsed lung, occurs when the lung separates from the inner chest wall. This causes the lung to collapse. A pneumothorax can be life-threatening because the lung stops working efficiently. The buildup of air in the chest cavity can compress the heart and major blood vessels, this situation is known as a tension pneumothorax.
A pneumothorax can be caused by trauma to the chest wall and rib fractures. For this reason, some CPR training candidates are concerned about the possibility of CPR resulting in a pneumothorax as a result of the deep chest compressions.
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Rib injuries are the most common complication of CPR, many patients undergoing effective CPR will suffer a rib or sternum fracture. A pneumothorax is less common but can occur because of the forces involved in giving effective chest compressions.
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The purpose of CPR is to save lives. Any complications from CPR can be treated afterwards. The most important consideration is early, effective CPR in the seconds to minutes after cardiac arrest.
Delays in initiating CPR are associated with poorer survival rates. In addition, weak or superficial chest compressions are much less effective. Therefore, each chest compression must be at least 5 cm deep to propel oxygenated blood to the brain and vital organs.
In short, don’t worry about the risk of causing injury (including pneumothorax) in a patient in cardiac arrest. Continue with hard and rapid chest compressions until medical help arrives. A pneumothorax is an abnormal buildup of air in the pleural space between the lung and the chest wall.
In a minority of cases, a one-way valve is formed by an area of damaged tissue and the amount of air in the space between the chest wall and the lungs increases; this is called a tsion pneumothorax.
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This can cause an increasing oxygen deficiency and low blood pressure. This leads to a type of shock called obstructive shock, which can be fatal unless reversed.
A primary spontaneous pneumothorax is one that occurs without an apparent cause and in the abscess of significant lung disease.
Smoking increases the risk of primary spontaneous pneumothorax, while the main underlying causes of secondary pneumothorax are COPD, asthma, and tuberculosis.
A traumatic pneumothorax can arise from physical trauma to the chest (including a blast) or from a complication of a healthcare intervention.
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Other conditions that can cause similar symptoms include a hemothorax (accumulation of blood in the pleural space), pulmonary embolism, and heart attack.
With a larger pneumothorax or shortness of breath, the air can be removed with a syringe or chest tube connected to a one-way valve system.
Occasionally, surgery may be necessary if the drainage of the tube is unsuccessful, or as a preventive measure, if there have been repeated episodes.
The surgical treatments usually include pleurodesis (where the layers of the pleura are glued together) or pleurectomy (the surgical removal of pleural membranes).
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A primary spontaneous pneumothorax (PSP) usually occurs in a young adult with no underlying lung problems and usually causes limited symptoms. Chest pain and sometimes mild shortness of breath are the usual predominant pressing features.
People affected by a PSP are often unaware of the potential danger and may wait several days before seeking medical attention.
PSPs are more common during changes in atmospheric pressure, which to some extent explains why episodes of pneumothorax can occur in clusters.
Secondary spontaneous pneumothoraces (SSPs) by definition occur in individuals with significant underlying lung disease. Symptoms in SSPs are usually more severe than in PSPs because the unaffected lungs are generally unable to replace the loss of function in the affected lungs. Hypoxemia (decreased oxygen levels in the blood) is usually perst and can be seen as cyanosis (blue discoloration of the lips and skin). Hypercapnia (accumulation of carbon dioxide in the blood) is sometimes counteracted; this can cause confusion and – if very severe – can lead to comas. The sudden onset of shortness of breath in someone with chronic obstructive pulmonary disease (COPD), cystic fibrosis, or other serious lung conditions should therefore prompt investigations to determine the possibility of a pneumothorax.
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Traumatic pneumothorax usually occurs when the chest wall is punctured, such as when a stab or gunshot wound allows air into the pleural space, or because another mechanical injury to the lung compromises the integrity of the structures involved. Traumatic pneumothoraces appear to occur in up to half of all chest trauma cases, with only rib fractures being more common in this group. The pneumothorax may be occult (not easily discernible) in half of these cases, but may be large – especially if mechanical ventilation is required.
On physical examination, breath sounds (heard with a stethoscope) on the affected side may be reduced, partly because air in the pleural space dampens the transmission of sound. Measures of the conduction of vocal vibrations to the surface of the chest can be modified. Chest percussion may be perceived as hyperresonant (such as a booming drum), and vocal resonance and tactile fremitus may both be noticeably reduced. Importantly, the volume of the pneumothorax may not correlate well with the severity of symptoms experienced by the victim,
Tsie pneumothorax is generally considered to be the cause when a pneumothorax (primary spontaneous, secondary spontaneous, or traumatic) leads to significant impairment of breathing and/or circulation.
This causes a type of circulatory shock called obstructive shock. Tsion pneumothorax can occur in clinical situations such as ventilation, resuscitation, trauma, or in people with lung disease.
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The most common findings in people with tsion pneumothorax are chest pain and respiratory distress, often with an increased heart rate (tachycardia) and rapid breathing (tachypnea) in the initial stages. Other findings may include quieter breathing sounds on one side of the chest, low oxygen levels and blood pressure, and displacement of the trachea away from the affected side. Rarely, there may be cyanosis (bluish discoloration of the skin due to low oxygen levels), altered level of consciousness, a hyper-resonant percussion tone on examination of the affected side with reduced expansion and movement, epigastrium (upper abdomen), displacement of the apex beat (heart pulse), and resonating sound when tapping the sternum.
Tsie pneumothorax can also occur in someone receiving mechanical ventilation, in which case it can be difficult to recognize because the person is usually given sedation; it is often noticed because of a sudden worsening of the condition.
Recent research has shown that the development of these characteristics does not always proceed as quickly as previously thought. Deviation of the trachea to one side and the presence of increased jugular pressure (jugular veins) are not reliable as clinical signs.
A schematic drawing of a bulla and a bleb, two lung abnormalities that can rupture and lead to pneumothorax
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Spontaneous pneumothoraces are divided into two types: primary, which occurs in the abscess of known lung disease, and secondary, which occurs in someone with underlying lung disease.
The cause of primary spontaneous pneumothorax is unknown, but established risk factors include being male, smoking, and a family history of pneumothorax.
Secondary spontaneous pneumothorax occurs in several lung diseases. The most common is chronic obstructive pulmonary disease (COPD), which accounts for about 70% of cases.
Other causes in children include measles, echinococcosis, inhalation of a foreign body, and certain birth defects (congenital lung abnormalities of the airways and congenital lobar emphysema).
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11.5% of people with a spontaneous pneumothorax have a family member who has had a pneumothorax before. The inherited disorders – Marfan syndrome, homocystinuria, Ehlers-Danlos syndromes, alpha-1 antitrypsin deficiency (leading to emphysema), and Birt-Hogg-Dubé syndrome – have all been associated with familial pneumothorax.
In general, these conditions also cause other signs and symptoms, and pneumothorax is usually not the primary finding.
Birt-Hogg-Dubé syndrome is caused by mutations in the FLCN ge (on chromosome 17p11.2), which codes for a protein called folliculin.
FLCN mutations and lung lesions have also been identified in familial cases of pneumothorax in which other features of Birt-Hogg-Dubé syndrome are absent.
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The most common mechanism is due to the damage of sharp bony points in a new rib fracture, which damages lung tissue.
Traumatic pneumothorax can also be observed in persons exposed to blast, even though there is no apparent injury to the chest.
They can be classified as “on” or “closed”. In a pneumothorax, there is a passage from the external vironmt to the pleural space through the chest wall. When air is drawn into the pleural space through this passage, it is known as a “sucking chest wound.” With a closed pneumothorax, the chest wall remains intact.
Medical procedures, such as inserting a ctral vous catheter into one of the chest veins or taking biopsy samples from lung tissue, can lead to a pneumothorax. The administration of positive pressure ventilation, either mechanical ventilation or non-invasive ventilation, can lead to barotrauma (pressure-related injury) leading to a pneumothorax.
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Divers breathing from an underwater device are given breathing gas at ambient pressure, causing their lungs to contain gas that is higher than atmospheric pressure. Divers breathing compressed air (such as wh
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