Tension pneumothorax

there is the introduction part of the torso trauma,
check out my next ppts for further more about torso trauma.
contents are in following order...
introduction
mechanism of injury
junctional zones of torso
tension pneumothorax
cardiac temponade
massive hemothorax
etc.
check out all slides

1. TENSION PNEUMOTHORAX Presented by : BHAVIKA SAHU Roll No. : 25 MBBS FINAL YEAR II DEPARTMENT OF SURGERY Lt.BRKM GMC JDP

2. Introduction Incidence Etiology Pathophysiology Clinical features -symptoms -signs Management Complications Differential diagnosis Bibliography CONTENTS

3. INTRODUCTION Pneumothorax is the presence of air between the layers of pleura. It is the most common cause of respiratory insufficiency following chest trauma. Pneumothorax can be – - closed(or simple) - open - tension

4. A tension Pneumothorax develops when ‘ one way valve ’ air leak occurs either from the lung or through the chest wall . It is an emergency condition. TENSION PNEUMOTHORAX

5. INCIDENCES Patients with trauma tend to have an associated pneumothorax or tension pneumothorax 20% of the time. In cases of severe chest trauma , there is an associated pneumothorax 50% of the time. The incidence of traumatic pneumothorax depends on the size and mechanism of injury.

6. ETIOLOGY TRAUMATIC Penetrating chest trauma Blunt force trauma Iatrogenic lung injury NONTRAUMATIC Mechanical positive pressure ventilation

7. PATHOPHSIOLOGY

8. CLINICAL FEATURES SYMPTOMS - ACUTE CHEST PAIN - SHORTNESS OF BREATH - RESTLESSNESS - ANXIETY

9. TACHYPNOEA CYANOSIS TACHYCARDIA JUGULAR VENOUS DISTENSION HYPOTENSIO N SIGNS

10. INSPECTION – Decreased chest movements PALPATION – Mediastinal and trachea shifts to the Contralateral side. PERCUSSION – Hyperresonant note. AUSCULTATION- Absent breath sounds.

11. MANAGEMENT TENSION PNEUMOTHORAX Is a CLINICAL DIAGNOSIS . Management should not Wait for Image confirmation. If the patient is hemodynamically unstable , then  immediate needle decompression must be performed without delay followed by ICD insertion and connected to underwater seal.

12. 14 -16 gauge needle is inserted through the chest wall . In 2 nd intercostal space– midclavicular line In 5 th intercostal space- just anterior to Mid axillary line

13. Patients with trauma tend to have an associated pneumothorax or tension pneumothorax 20% of the time. In cases of severe chest trauma, there is an associated pneumothorax 50% of the time. The incidence of traumatic pneumothorax depends on the size and mechanism of injury. It is temporizing measure – it convert TENSION PNEUMOTHORAX SIMPLE PNEUMOTHORAX It is temporizing measure – it convert TENSION PNEUMOTHORAX SIMPLE PNEUMOTHORAX

14. TRIANGLE OF SAFETY

15. INTERCOSTAL CHEST TUBE

16. Chest tubes are always connected to an underwater seal bag to prevent air from re – entering . Functioning of chest tube is assessed by movement of column of fluid in the water bag . Position of the chest tube checked by taking chest X-ray

17. INVESTIGATION CHEST X-RAY

18. e-FAST Bar code sign

19. RESPIRATORY FAILURE RESPIRATORY ARREST CARDIAC ARREST SUBCUTANEOUS EMPHYSEMA PNEUMOPERICARDIUM PNEUMOPERITONEUM COMPLICATIONS

20. PROCEDURE COMPLICATIONS Fistula formation Infections Bleeding Intercostal nerve injury

21. DIFFERENTIAL DIAGNOSIS CARDIAC TAMPONADE HEMOTHORAX PULMONARY EMBOLISM MYOCARDIAL INFARCTION ACUTE AORTIC DISSECTION RIB FRACTURE COSTOCHONDRITIS DIAPHRAGMATIC INJURY

22. BIBLIOGRAPHY BAILEY AND LOVE SRB’S MANUAL OF SURGERY

23. THANK YOU