Traumatic Pneumothorax

WHAT YOU SHOULD KNOW:

• A pneumothorax is a condition in which air collects in the pleural space (the space between your lung and chest wall). A traumatic pneumothorax is caused by an injury that causes air to leak into your pleural space. The air that builds up in the pleural space stops the lung from filling with air, and the lung collapses. A pneumothorax can happen in one or both of your lungs.
  
  
• A traumatic pneumothorax can be caused by a broken rib that tears your lung. Other causes include injuries that allow air to enter from the outside, such as a knife or gunshot wound. Motor vehicle accidents, falls, or injuries from medical procedures can also cause traumatic pneumothorax. Symptoms of a traumatic pneumothorax include chest pain, rapid heartbeat, or shortness of breath. You may feel air bubbles under your skin anywhere on your body, such as your chest or neck. With fast and proper treatment, your pneumothorax may get better. A traumatic pneumothorax can heal on its own, or become a persistent posttraumatic pneumothorax (PPP). A PPP is a pneumothorax that does not heal within a certain period of time after treatment.
  
  
• A traumatic pneumothorax can also develop into a traumatic tension pneumothorax. This means your pneumothorax becomes serious enough to affect the way your heart and lungs work. A traumatic tension pneumothorax may cause one or both of your lungs to completely collapse. Your neck veins may be larger than usual, and your heart may beat faster than usual. Your fingernails, toes and lips may turn blue. A traumatic tension pneumothorax can result in death if not treated quickly.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

RISKS:

• Some treatments may cause breathing problems or problems in your heart or blood vessels. Treatments that require incisions (cuts) in your skin to get to the lung area may lead to empyema. Empyema is an infection in the lung area. You could get a traumatic tension pneumothorax if you are put on a ventilator without chest tubes. You could also get a traumatic tension pneumothorax during pleurodesis.
  
  
• During decompression, the needle used for the procedure may injure your lung or cut a blood vessel. This could cause bleeding around the lung. Chest tubes could be painful, become kinked or clogged, or could fall out or leak. Chest tubes could also cause a lung infection, or fluid could fill the lung instead of air. Chest tubes could damage your blood vessels or other organs and cause bleeding, injury, and even death.
  
  
• Without treatment of your traumatic pneumothorax, your lungs may completely collapse. Your heart could stop working, and you could die. Ask your caregiver if you have any questions about your treatment, condition, or care.

WHILE YOU ARE HERE:

• Informed consent: A consent form is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.
  
  
• Vital signs: Caregivers will check your blood pressure, heart rate, breathing rate, and temperature. They will also ask about your pain. These vital signs give caregivers information about your current health.
  
  
• IV: An IV (intravenous) is a small tube placed in your vein that is used to give you medicine or liquids.
  
  
• Oxygen: You may need extra oxygen if your blood oxygen level is lower than it should be. You may get oxygen through a mask placed over your nose and mouth or through small tubes placed in your nostrils. Ask your caregiver before you take off the mask or oxygen tubing.
  
  
• Pulse oximeter: A pulse oximeter is a device that measures the amount of oxygen in your blood. A cord with a clip or sticky strip is placed on your finger, ear, or toe. The other end of the cord is hooked to a machine. Never turn the pulse oximeter or alarm off. An alarm will sound if your oxygen level is low or cannot be read.
  
  
• ECG: An ECG helps caregivers look for damage and problems in your heart. Sticky pads are placed on your skin. Each sticky pad has a wire that is hooked up to a machine or a TV-type screen. An ECG measures the electrical activity of your heart. Caregivers look for certain problems or changes in the way your heart is working.
  
  
• Medicines:
  
  
  • Pain medicine: Caregivers may give you medicine to decrease your pain. Tell caregivers if the pain does not go away or it comes back.
    
    
  • Antibiotic medicine: Antibiotics may be given to you to prevent an infection caused by germs called bacteria.
    
    
  • Sedation: Caregivers may give you medicine to relax you.
  
  
• Tests: You may need one or more of the following tests to help caregivers plan your treatment:
  
  
  • Blood gases: This is also called an arterial blood gas, or ABG. Blood is taken from an artery (blood vessel) in your wrist, arm, or groin. Your blood is tested for the amount of oxygen and carbon dioxide in it. The results can tell caregivers how well your lungs are working.
    
    
  • Blood tests: Blood is taken from a vein in your hand, arm, or the bend in your elbow. It is test to see how your body is handling your condition. You may need more than one blood test.
    
    
  • Chest x-ray: Chest x-rays are pictures of the bones, lungs, and other tissues in your chest. Caregivers use chest x-rays to see if you have broken ribs. These x-rays may show your caregiver how large your pneumothorax is. Chest x-rays may also show fluid around the heart and lungs.
    
    
  • Computerized tomography scan: This test is also called a CT or CAT scan. A CT scan uses a special x-ray machine to take pictures of your chest and lungs. You may be given dye through an IV before the pictures are taken. The dye helps the pictures show up better. People who are allergic to iodine or shellfish (lobster, crab, or shrimp) may be allergic to this dye. Tell caregivers if you are allergic to shellfish or you have other allergies.
    
    
  • Ultrasound: An ultrasound uses sound waves to show pictures of your lungs on a TV-like screen.
  
  
• Treatment options: You may need one or more of the following:
  
  
  • Procedures: You may receive a medicine called local anesthesia to make you feel more comfortable during your procedure or surgery. A shot of this medicine put into your skin numbs the area and dulls your pain. You may still feel pressure or pushing during the procedure or surgery after you get this medicine.
    
    
    • Decompression: A needle may be put in between your ribs to remove air from around your lungs. Your caregiver may need to put a catheter (rubber tube) through your skin and into your pleural space. A valve that lets air out of your pleural space may be connected to the catheter.
      
      
    • Pleurodesis: If your pneumothorax is not healing, caregivers may put blood, talc, or antibiotics into the pleural space. These products cause your lung to stick to the visceral pleura (a thin layer of tissue attached to your lung). Attaching the lung to the visceral pleura stops air from getting into your pleural space. These products can be placed during surgery or with the use of chest tubes.
      
      
    • Thoracostomy: A thoracostomy is a procedure in which caregivers put a chest tube through an incision (cut) in your skin. The chest tube is then placed into your chest. Chest tubes remove air, blood, or fluid from around your lungs or heart.
      
      
    • Thoracotomy: You may need surgery to treat injuries that cannot be treated in other ways. These injuries include tears in your lungs, bleeding blood vessels, and other injured tissues.
      
      
    • Video-assisted thoracoscopic surgery: This surgery is also called VATS. If air or blood continues to leak from around your lung, you may need VATS. During VATS, catheters are inserted through a cut in your skin and into the lung area. One catheter has a camera at the end that allows caregivers to see the lung. Other catheters may have special devices attached that are used to treat your lung injuries.
    
    
  • Ventilation: You may need a machine called a ventilator to help you breathe. If so, a chest tube may be put in to decrease the risk of a tension pneumothorax.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

Learn more about Traumatic Pneumothorax (Inpatient Care)