Tension Pneumothorax

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Tension pneumothorax is described as the continuous leakage of air from the lungs and into the chest cavity. Because of the one-way valve created, there becomes an increased intrapleural pressure. This results to the compression of the structures found in the chest, including blood vessels, such as the veins, interfering with the venous return. It frequently occurs as a result of an open pneumothorax that results from a penetrating wound to the chest.  Tension pneumothorax is also described as a complete collapse of the lung. Tension pneumothorax is fatal, especially if not treated immediately, as it can cause cardiovascular collapse and shock. It is a life threatening emergency that requires medical attention as soon as possible.

Causes of Tension Pneumothorax

Tension pneumothorax typically results from an open pneumothorax. However, anything that leads to pneumothorax can lead to tension pneumothorax. Pneumothorax is defined as the accumulation of air in the pleural cavity leading to partial or complete collapse of the affected lung. The following are the common causes of tension pneumothorax:

  • Stab wounds
  • Gunshot wounds
  • Bite wounds
  • Wounds from explosions and other blast injuries

Signs and Symptoms of Tension Pneumothorax

The following are the signs and symptoms of tension pneumothorax:

  • Abrupt chest pain
  • Chest tightness
  • Dyspnea or shortness of breath paired with rapid breathing
  • Cyanosis of the skin (bluish color)
  • Quick heart rate
  • Hypotension
  • Easy fatigue
  • Decreased consciousness and mental alertness
  • Bulging (distended) veins in the neck
Chest Discomfort or Pain
Chest pain and tightness is a common symptom of tension pneumothorax

First Aid Management for Tension Pneumothorax

Tension pneumothorax requires immediate medical attention. Thus, at first signs and symptoms of tension pneumothorax, call the local emergency number. It is not always easy to diagnose, hence, all cases of pneumothorax should be treated as tension pneumothorax. The following should be done in cases of tension pneumothorax to give proper first aid treatment to a casualty:

  • Apply sterile occlusive dressing to the wound. Dressing should also be nonporous. To do this, apply a tape dressing on only three of the four sides allowing air to escape from the pleural cavity but not reenter. This is called a Valve effect. One can make use of a plastic wrapping.
  • If one is trained to place a chest tube, do so. This is the primary management for an open chest wound. The wound should not be completely occluded until the chest tube is in place.

Tension pneumothorax occurs when air enters but does not leave the pleural cavity, creating a one-way-valve. In turn, the organs in the chest are compressed, which can lead to partial or total collapse of the lung. To learn more about how to manage tension pneumothorax and other kinds of medical emergencies, enroll in First Aid and CPR Courses.


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