Large pneumothorax - early tension

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Large pneumothorax - early tension

  • A large pneumothorax is usually easy to recognise, but always check for signs of tension.
  • Rising pressure within a hemithorax reduces venous flow to the heart, potentially leading to rapid death.

Signs of tension

  • Right heart border (white arrows) and left heart border (black arrows) shifted to the left
  • Right hemidiaphragm slightly depressed - should be higher than the left
  • Minor shift of the trachea - unlikely to be clinically detectable
  • Don't waste time discussing the exact definition of a tension pneumothorax - this patient needs attention - NOW! Start with ABC and get help