Have you ever seen or managed a patient with tension pneumothorax? Share your experiences and thoughts 👇 Learn more about Emergency Medicine on Lecturio ► lectur.io/emergencymedicinecoursepage
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I had a spontaneous tension pneumothorax (right lung) Thanksgiving morning of this year (2024). Very scary, I thoutht I was a goner. Since then, I've been trying to learn everything I can about it. Thank you for this video, very informative.
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Very good video. I'm curious, at 5:00 the X-ray shows depression on the traumatic side. I'd think that the pressure in the chest cavity would balance and the diaphram would equalize? Therefore the depression on the patients left side would also be shown on the right side? I'm really curious why it doesn't present this way.
Thanks for the great question! 🙌 You're right to be curious about how the diaphragm behaves during a tension pneumothorax. In this case, the high pressure from the air trapped in the pleural space (on the injured side) actually pushes the diaphragm down, causing it to appear lower on that side. The unaffected side remains normal because the pressure is localized to the side of the injury, and the unaffected lung isn't compressed. This creates the unequal appearance you noticed in the X-ray.
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Had a dry needling session done that caused me a small pneumothorax. Is there a chance of re occurence ? I still have chest pain amlost 1 year later . All my drs say no but i am starting to believe they are wrong. I did not need surgery or a cheat tube. Have had multiple mri/chest x ray and no evidence of another since . But would u know the answer to this ?
So I had a tension pneumothorax in December right before Christmas due to pulmonary blebs. I was on vacation out of state. They did an ekg first then insisted on an xray. I could not stand up as every time I moved my entire right side cracked and it was like a tire iron smacking my entire side. Forget that I was gray with purple spots, couldn't talk, move, and my deepest breath was like taking a mouthful at a time. Nope need to stand for an xray. Over 2 hrs in the er I fell in and out consciousness multiple times, the pain finally built to the point that I thrashed to the floor and forced myself to stand. Xray showed a complete collapse (obviously) and trachea was way over and left lung was about 20% collapse. No decompression, jist a 32 French tube and a wall vacuum AFTER the doctor drove in. So with time to get to the hospital about 4 hrs of that shit) was about 2am now. 5pm next day I was at in laws and drove 5 hrs home the following day. Lung was still about * 0% collapsed and no I didn't sign an ama. Got it back up finally right before new years. Again on January 12, had surgery January 14 (wedge resection and non talc pleurodesis) go home January 17, collapsed again January 24 (follow up xray showed I had no idea, 20%) was also hemothorax. I'm fine now, aside from sometimes my nipple is kinda sensitive I can run, work, do everything as normal as if it never happened. So... It is a medical emergency but get to hospital and you'll be fine.
I had an episode in the shops where I rushed to get something nearly collapsed couldn't breathe for a bit & felt like I broke ribs but after a while I could breathe but haven't felt good since that day I was wondering why I was sniffing felt like I wasn't getting enough air so how would I know it's bad enough to get checked
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Thank you for the great feedback! 😊 Muffled heart sounds can be a key clinical sign, especially in conditions like cardiac tamponade, where fluid builds up in the pericardial space, compressing the heart. In the context of a tension pneumothorax, however, the heart sounds can also become muffled due to the increased pressure in the chest cavity, which can push the heart away from the chest wall, making it harder to hear during auscultation.
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another memory hook that wasnt mentioned; for Spontaneous pneumo the trachea deviates to the Same side. for Tension the trachea shifts away, and the hook is you wanna keep Tension Away from you
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Great informative video thank you. Wondering if tension pneumo is a possibility in a pt that begins as simple pneumothorax? I work the inpatient setting, had a recent ptx from misplaced gastric tube pt was in distress very hypoxic but no hemodynamic instability. Could this have eventually become tension pneumothorax? Thank you!
Thank you for your insightful question! 😊 Yes, a simple pneumothorax can evolve into a tension pneumothorax if the underlying injury to the lung or pleura creates a one-way valve effect. In the scenario you described, where the patient was in distress and hypoxic but not yet experiencing hemodynamic instability, it’s possible that with time, air could have continued to accumulate in the pleural space, leading to increased pressure and eventual tension pneumothorax. This can cause the mediastinum to shift, impairing venous return and leading to hemodynamic compromise.
Good question! You do not need to cover the wound before performing needle decompression for a tension pneumothorax. The goal of needle decompression is to rapidly relieve the pressure in the pleural space, and this takes priority. Covering the wound, especially in an emergency, can delay this critical procedure. Once the needle decompression is done and the patient is stabilized, a chest tube can be inserted for definitive treatment. Afterward, any open wounds can be appropriately dressed and sealed to prevent further air entry into the chest cavity. For more hands-on tips and demonstrations on emergency procedures like these, consider signing up for a 7-day free trial at lectur.io/freecontentyt! 🩺
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Needle decompression is an emergency procedure used to quickly relieve pressure in the chest caused by a tension pneumothorax. A large needle is inserted into the pleural space to release trapped air, providing immediate but temporary relief. On the other hand, a pleural drain (chest tube) is a more definitive, long-term solution used to continuously drain air, fluid, or blood from the pleural space. This allows the lung to re-expand and is left in place until the issue is fully resolved. Needle decompression stabilizes the patient, while a pleural drain treats the underlying problem.
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Treatment for TB was to inject air into the pleura space which causes iatrogenic pneumothorax this now commonly called artificial pneumothorax to identicate TB treatment.
While trauma is a common cause of tension pneumothorax, other conditions, like tuberculosis (TB), can also lead to it. In cases of TB, a tension pneumothorax can occur when a weakened area of the lung ruptures, allowing air to escape into the pleural space and creating that one-way valve effect. This can result in the same dangerous buildup of pressure that we see in traumatic cases. It’s important to recognize that any underlying lung pathology-whether from infection, chronic disease, or trauma-can potentially lead to tension pneumothorax.
Am I right in saying that at the start of the video she is explaining an open pneumothorax that has lead to a tension pneumothorax? I was under the impression that simple,spontanious and open pneumothorax could lead to a tension pneumothorax but only in the later stages for example you could get an open pneumothorax without it being a tension pneumothorax unless left untreated? Please correct me if i am wrong
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I had pneumothorax and hemothorax cause i was stabbed numerous times on my upper back it has been 6 months already and i feel pretty good .... one question , can i hold my breath?
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Great observation! The Hamman’s crunch is a distinctive sound that can sometimes be heard in patients with a pneumothorax, particularly in cases of pneumomediastinum. It’s a crunching or crackling noise, typically synchronous with the heartbeat, rather than breathing. This sound is created by air trapped in the mediastinum moving with the cardiac cycle, and is best heard in the left lateral decubitus position.
Have you ever seen or managed a patient with tension pneumothorax? Share your experiences and thoughts 👇
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I'm studying to play a role of a Dr. who does this procedure, outstanding teaching, you make it exceedingly clear. Thank you.
Absolutely fantastic video. very clear, very well presented, not over complicated and covered everything . Top marks from me.
Wonderful explanation
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Such clarity and brivity - Totally awestruck
I had a spontaneous tension pneumothorax (right lung) Thanksgiving morning of this year (2024). Very scary, I thoutht I was a goner. Since then, I've been trying to learn everything I can about it. Thank you for this video, very informative.
This person is an amazing teacher! This was a GREAT review! Thanks.👋🧑🏾⚕️
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Outstanding , absolutely beneficial vid.
Thank you ma'am 😃
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This video is so informative and helpful to understand!! Thanks.
An excellent presentation on TP. Very impressive.
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Really helpful for my tomorrow exam 👍😊🇮🇩
Excellent presentation
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This channel is a great resource
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Wonder who would unlike such a beautiful and easily understandable video ... thanks for the great video
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excellent teacher and excellent presentation. thanx!
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she is becoming my new fav tacher
outstanding elaboration
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This was such a good video. Thank you
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In the last ATLS they recommended to place the needle in the 5th intercostal space in Mid axilar line. The success rate is much better
Jorge A Castro Espinoza **slightly anterior to mid axillary line
In the Army, the medics told us Third intercostal space.
It states 2nd to 5th ics, whatever works at the moment
It is stated in the slide.
I had it working many times in the anterior position at the midclavc line. It's nice to have as many possibilities as possible
This lady is gem
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Thank you so much ! Easy to follow and understand !
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Super informative! She's a great presenter.
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Thanks for a very informative and excellent description of this material!!
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Superb explanation
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Very informative video! Studying for my CEN and this really puts it all together for me. Thanks!
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Very good video. I'm curious, at 5:00 the X-ray shows depression on the traumatic side. I'd think that the pressure in the chest cavity would balance and the diaphram would equalize? Therefore the depression on the patients left side would also be shown on the right side? I'm really curious why it doesn't present this way.
Thanks for the great question! 🙌 You're right to be curious about how the diaphragm behaves during a tension pneumothorax. In this case, the high pressure from the air trapped in the pleural space (on the injured side) actually pushes the diaphragm down, causing it to appear lower on that side. The unaffected side remains normal because the pressure is localized to the side of the injury, and the unaffected lung isn't compressed. This creates the unequal appearance you noticed in the X-ray.
@@lecturiomedical Ok! That makes a lot of sense. Thanks for getting back on this!
Outstanding video, clear throughout
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Detailed teaching with good illustrations.
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You’re wording is wonderful. Thank you
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oh my! She is an awesome teacher!!
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Awesome content! Study with me and review med school topics!
Excellent video ❤
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Really good, clear and easy to understand
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Had a dry needling session done that caused me a small pneumothorax. Is there a chance of re occurence ? I still have chest pain amlost 1 year later . All my drs say no but i am starting to believe they are wrong. I did not need surgery or a cheat tube. Have had multiple mri/chest x ray and no evidence of another since . But would u know the answer to this ?
So I had a tension pneumothorax in December right before Christmas due to pulmonary blebs. I was on vacation out of state. They did an ekg first then insisted on an xray. I could not stand up as every time I moved my entire right side cracked and it was like a tire iron smacking my entire side. Forget that I was gray with purple spots, couldn't talk, move, and my deepest breath was like taking a mouthful at a time. Nope need to stand for an xray. Over 2 hrs in the er I fell in and out consciousness multiple times, the pain finally built to the point that I thrashed to the floor and forced myself to stand. Xray showed a complete collapse (obviously) and trachea was way over and left lung was about 20% collapse. No decompression, jist a 32 French tube and a wall vacuum AFTER the doctor drove in. So with time to get to the hospital about 4 hrs of that shit) was about 2am now. 5pm next day I was at in laws and drove 5 hrs home the following day. Lung was still about * 0% collapsed and no I didn't sign an ama. Got it back up finally right before new years. Again on January 12, had surgery January 14 (wedge resection and non talc pleurodesis) go home January 17, collapsed again January 24 (follow up xray showed I had no idea, 20%) was also hemothorax. I'm fine now, aside from sometimes my nipple is kinda sensitive I can run, work, do everything as normal as if it never happened. So... It is a medical emergency but get to hospital and you'll be fine.
I had an episode in the shops where I rushed to get something nearly collapsed couldn't breathe for a bit & felt like I broke ribs but after a while I could breathe but haven't felt good since that day I was wondering why I was sniffing felt like I wasn't getting enough air so how would I know it's bad enough to get checked
Thats crazy! So glad you are all good now. Any idea what the heck why this happened?
excellent video! thank you
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Fantastic, many thanks.
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Great video, concise and straight to the point. Muffled heart sounds?
Thank you for the great feedback! 😊 Muffled heart sounds can be a key clinical sign, especially in conditions like cardiac tamponade, where fluid builds up in the pericardial space, compressing the heart. In the context of a tension pneumothorax, however, the heart sounds can also become muffled due to the increased pressure in the chest cavity, which can push the heart away from the chest wall, making it harder to hear during auscultation.
Amazing lect on pneumothorax ...
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very clear lecture, Thank you ma'am!
wham bam
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Thank you! I understand this much better now!!
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Thanks madam, short and nice explanation.
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Lovely presentation
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Thank you for this video
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very good and informative video thank you
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I love this video.😍
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Thank you! You made it easier
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Thank you so much.
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Wow what a great video
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well resumed.many thanks
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It was really helpful.
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Once the chest has been decompressed, do you leave the cap off or on the end of the cannula?
Very educative, thank you so much.
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Awesome video 👍
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Does treatment still remain, when tension pneumothorax occurs in a patient during a flight, since atmospheric pressure is likely to differ
another memory hook that wasnt mentioned; for Spontaneous pneumo the trachea deviates to the Same side. for Tension the trachea shifts away, and the hook is you wanna keep Tension Away from you
That's a fantastic memory hook! 🌟 Thanks for sharing this tip! If you're interested in more clinical pearls and memory aids, don’t hesitate to explore deeper with a 7-day free trial at Lecturio 👉 lectur.io/freecontentyt. Keep learning and sharing your wisdom! 😊
fantastic, pretty expert
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Very helpful
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She is good !
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Clear cut
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Do lecturio have quizes in tge app version after each video?
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Useful video
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best lecture
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Is 2 nd intercostal space related to Costco mediastinal recesses??
Thank goodness
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Thank you very much Madam
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Thanks for knowledge
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Thank you very much for the great explanation!
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thanks doc.
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Thank you🙏🏼
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Great informative video thank you. Wondering if tension pneumo is a possibility in a pt that begins as simple pneumothorax? I work the inpatient setting, had a recent ptx from misplaced gastric tube pt was in distress very hypoxic but no hemodynamic instability. Could this have eventually become tension pneumothorax? Thank you!
Thank you for your insightful question! 😊 Yes, a simple pneumothorax can evolve into a tension pneumothorax if the underlying injury to the lung or pleura creates a one-way valve effect. In the scenario you described, where the patient was in distress and hypoxic but not yet experiencing hemodynamic instability, it’s possible that with time, air could have continued to accumulate in the pleural space, leading to increased pressure and eventual tension pneumothorax. This can cause the mediastinum to shift, impairing venous return and leading to hemodynamic compromise.
Should we cover the wound before inserting the decompression needle?
Good question! You do not need to cover the wound before performing needle decompression for a tension pneumothorax. The goal of needle decompression is to rapidly relieve the pressure in the pleural space, and this takes priority. Covering the wound, especially in an emergency, can delay this critical procedure.
Once the needle decompression is done and the patient is stabilized, a chest tube can be inserted for definitive treatment. Afterward, any open wounds can be appropriately dressed and sealed to prevent further air entry into the chest cavity.
For more hands-on tips and demonstrations on emergency procedures like these, consider signing up for a 7-day free trial at lectur.io/freecontentyt! 🩺
Good information. Thanks!
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Good explain thank you a lot doctor
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Wow...I love it...
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Please what the difference between
Needle decompression and pleural drain?
Needle decompression is an emergency procedure used to quickly relieve pressure in the chest caused by a tension pneumothorax. A large needle is inserted into the pleural space to release trapped air, providing immediate but temporary relief. On the other hand, a pleural drain (chest tube) is a more definitive, long-term solution used to continuously drain air, fluid, or blood from the pleural space. This allows the lung to re-expand and is left in place until the issue is fully resolved. Needle decompression stabilizes the patient, while a pleural drain treats the underlying problem.
thank u so much it was reallyyy helpfull
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Thank you 😊
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Thank you.
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Very well explained
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Very nice presentation... thank you a lot
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Thanks
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Great,Thank you very much!
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Thank you so much! 23/12/2021
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Bravooooooooo👏🏻👏🏻👏🏻👏🏻👏🏻
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great presentation thanks :)
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Thanks mam...
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Tension pneumothorax can be there not only because of trauma.. TB can also cause tension pneumothorax
Treatment for TB was to inject air into the pleura space which causes iatrogenic pneumothorax this now commonly called artificial pneumothorax to identicate TB treatment.
TB doesn't actually cause it but to treat it traumatic secondary pneumothorax is the result
While trauma is a common cause of tension pneumothorax, other conditions, like tuberculosis (TB), can also lead to it. In cases of TB, a tension pneumothorax can occur when a weakened area of the lung ruptures, allowing air to escape into the pleural space and creating that one-way valve effect. This can result in the same dangerous buildup of pressure that we see in traumatic cases. It’s important to recognize that any underlying lung pathology-whether from infection, chronic disease, or trauma-can potentially lead to tension pneumothorax.
“Insert the needle as far as it goes”. I always thought it was until you get air release out of the plural space, then advance the catheter only.
Love you mam.. excellent
Am I right in saying that at the start of the video she is explaining an open pneumothorax that has lead to a tension pneumothorax? I was under the impression that simple,spontanious and open pneumothorax could lead to a tension pneumothorax but only in the later stages for example you could get an open pneumothorax without it being a tension pneumothorax unless left untreated?
Please correct me if i am wrong
great thanks
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Love it!!!!!!
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Thanks
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really awsum tqu fr dis vedio
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I dont understand why giving C PAP can worsen tension pneumothorax but supplemental O2 can't? Please can you explain. Thanks
How long do patients usually stay in the hospital for tension pneumothorax?
Apne ki Bangla bujhe. Tahole kicu kotha bolta??
Life every time addmited hospital...other site patient will be died
I had pneumothorax and hemothorax cause i was stabbed numerous times on my upper back it has been 6 months already and i feel pretty good .... one question , can i hold my breath?
Thank God for saving you. Give Him your life. He has preserved you for a reason. Ecclesiastes 12:13,14.
Thks
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Hi I had a pneumothorax 6 months ago my question would be can I smoke a cigarette now?
There's never a good time for a cigarette. (Thoughts from a former smoker)
you forgot to discribe about - hamman crunch sign (sound)
What is the hamman crunch sign sound?
Great observation! The Hamman’s crunch is a distinctive sound that can sometimes be heard in patients with a pneumothorax, particularly in cases of pneumomediastinum. It’s a crunching or crackling noise, typically synchronous with the heartbeat, rather than breathing. This sound is created by air trapped in the mediastinum moving with the cardiac cycle, and is best heard in the left lateral decubitus position.
Is the patient awake for the whole experience, or are they put on anesticia?
I was awake for the whole thing. Had a tension pneumothorax on Thanksgiving morning of this year