Acute respiratory failure due to pneumothorax

The article was written by MSc Phan Van Phong - Emergency Department - Vinmec Central Park International General Hospital

Severe pneumothorax (valvular pneumothorax) severe shortness of breath, signs of acute respiratory failure: cyanosis, palpitations, rapid pulse, low blood pressure (shock state) requiring treatment measures timely first aid.

1. Immediately necessary clinical signs (medical record form)

Shortness of breath Chest pain suggestive of pneumothorax Low blood pressure: severe sign requiring immediate emergency intervention Pulmonary ultrasound: no sign of lung sliding, lung point Assess for trauma if present

Ép tim khó thở — Khó thở là một dấu hiệu của tình trạng cần cấp cứu khi bị tràn khí màng phổi

2. Laboratory requirements and emergency investigation

Blood tests: POCT, complete blood count, coagulation, arterial blood gases 12-lead electrocardiogram, chest X-ray at bed, ultrasound of abdomen, lungs at bed. Consider CT scanner if patient is stable Probe/monitor: continuously monitor SpO2, heart rate, BP

3. Emergency treatment

3.1 Specific emergency management

Pressure pneumothorax Immediately insert a catheter (Venflon) with a plastic one-way valve with an iron barrel into the pleural space at a position above the midclavicular line corresponding to the second intercostal space. Save the needle until a pleural drain is placed.

Hình ảnh — Hướng dẫn xử trí cấp cứu đặc hiệu

Non-pressure pneumothorax If the air ring (rim of air from chest wall to the pleura) < 2 cm without dyspnea may not require immediate intervention, re-evaluate the patient If the air ring is > 2 cm and or having difficulty breathing: insert a chest drain. Wound penetrates the chest. Suction in place and cover the wound while waiting for chest drainage

3.2 Emergency treatments to stabilize the patient

Provide high-flow oxygen (≥ 28%) to patients with SpO2 > 92%
High head position Chest drainage
Indications: Pressure pneumothorax, trauma, postoperative, procedure, age > 50, air ring > 2 cm Location: Perform at the safety triangle Size: suitable, avoid causing air leaks Suction pressure: from -10 to -20 cm H2O Check X-ray after performing the procedure jutsu

Vinmec International General Hospital is one of the hospitals that not only ensures professional quality with a team of leading medical doctors, a system of modern equipment and technology. The hospital provides comprehensive and professional medical examination, consultation and treatment services, with a civilized, polite, safe and sterile medical examination and treatment space.

Để đặt lịch khám tại viện, Quý khách vui lòng bấm số HOTLINE hoặc đặt lịch trực tiếp TẠI ĐÂY. Tải và đặt lịch khám tự động trên ứng dụng MyVinmec để quản lý, theo dõi lịch và đặt hẹn mọi lúc mọi nơi ngay trên ứng dụng.

XEM THÊM: