A pneumothorax is simply a partially or totally collapsed lung that happens when the lung develops a hole and air issues into the space between the lung and the pleura. It can arise due to an injury such as may occur with a broken rib, or due to illness like COPD or pneumonia, or it may occur spontaneously.[1]
Symptoms include sudden chest pain and shortness of breath.[2] There is also an increased respiratory rate and diminished air entry into the affected lung.[3] The skin will become bluish and veins in the neck may become distended. If you listen to the affected lung with a stethoscope, you may hear nothing at all or it may sound like Rice Krispies when the milk is poured on.[4]
Males 20-40 years old and tall and underweight are at increased risk for the ruptured air blister-type pneumothorax.[5]
Other risk factors for all:
- Smoking. The risk increases the longer and the more a person has smoked.
- Genetics. Some types of pneumothorax run in families.
- Lung disease. Any lung disease, but especially COPD, increases the risk of pneumothorax.
- Previous pneumothorax. Anyone who has previously experienced pneumothorax is at greater risk.
- Mechanical ventilation. Mechanical ventilation for breathing assistance also increases the risk of pneumothorax.[6]
The supplies needed to treat include the following:
- 50 ml syringe
- three-way stopcock
- IV tubing
- 14-18 g needle, at least 1 1/2 inches long
Using a long needle, pass the needle through the second intercostal space/mid-clavicular line and aspirate air into a 50 ml syringe, using a three-way tap, until you have removed 1-2 litres.[8]
And this is what The Survival Doctor has to say:
The needle is going to need to be one-and-a-half inches, or longer, to get into the chest cavity. As you go in, pull back on the syringe. You’ll know you’re in the right place if you start pulling back air. Don’t go further or you could stick the lung and make it worse. Also, there’s always the risk for infection. In other words, like most medical procedures, this can be dangerous. Only do it as a last resort in someone who looks like they’re not going to last long enough to get expert medical care.[9]
References:
[1] https://www.mayoclinic.org/diseases-conditions/pneumothorax/symptoms-causes/syc-20350367 (accessed 22 July 2020).
[2] Ibid.
[3] Survival and Austere Medicine, 3rd Edition, 131.
[4] Joseph Alton, The Survival Medicine Handbook, 359.
[5] https://www.mayoclinic.org/diseases-conditions/pneumothorax/symptoms-causes/syc-20350367
[6] Ibid.
[7] http://thesurvivaldoctor.com/2012/11/27/collapsed-lung/ (accessed 22 July 2020).
[8] Survival and Austere Medicine, 3rd Edition, 132.
[9] http://thesurvivaldoctor.com/2012/11/27/collapsed-lung/ (accessed 22 July 2020).
7 october 2020
The hard part about a pneumothorax is knowing it is there. A complete or near complete pneumo is possible to diagnose clinically.....if you have the knowledge and experience. The vast majority of pneumos are partial. And almost impossible to diagnose without an x ray. And sticking a needle into the pleural cavity unnecessarily can often create or exacerbate a pneumothorax.
ReplyDeleteRight. As noted in the article, the vast majority of pneumothorax cases are partial. 90% of the time, doing nothing is the best solution. If it is a life-threatening pneumothorax, as best as one can tell in an austere situation where there is no higher medical help at all, death is already a given without intervention. Thank you for your comment.
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