Ver el código de «Tension pneumothorax»

==Background==
*Death occurs from hypoxic respiratory arrest (V-Q mismatch), not circulatory arrest

==Clinical Features==
*Unilateral diminished or absent breath sounds
*[[Hypotension]] or evidence of hypoperfusion
*Distended neck veins
**May not occur if patient is hypovolemic
*Contralateral Tracheal deviation (late sign)
*Type of obstructive shock since prevents venous return to the right side of the heart

==Differential Diagnosis==
{{Pneumothorax types}}
{{Thoracic trauma DDX}}
{{SOB DDX}}

==Evaluation==
[[File:PMC2892654 CRM2010-213818.004.png|thumb|Left sided tension pneumothorax with mediastinal shift]]
'''Ideally a clinical diagnosis treated emergently (without delay for studies)'''
*[[CXR]]
*[[Ultrasound: Lungs|Lung ultrasound]]

{{Lung ultrasound pneumothorax}}

==Management==
*Immediate [[needle thoracostomy]]
**14ga IV in midclavicular line just above the rib at the second intercostal space
**Evidence suggests lowest failure rate of needle decompression is at the 4th/5th rib space along the anterior axillary line <ref>Laan DV et al. Chest Wall Thickness and Decompression Failure: A systematic Review and Meta-Analysis Coparing Anatomic Locations in Needle Thoracostomy. Injury 2015 [Epub Ahead of Print]. PMID: 26724173</ref>
*Always followed by [[Chest Tube]] placement
'''Pediatric Chest Tube'''
*Estimated as 4*ETT
**ETT=(4+age/4)

{{Chest tube size table}}

==Disposition==
*Admit

{{Flying instructions after pneumothorax}}

==Complications==
*[[Reexpansion pulmonary edema]]

==See Also==
*[[Pneumothorax (main)]]
*[[Needle thoracostomy]]
*[[Finger Thoracostomy]]
*[[Adult pulseless arrest#Asystole and PEA (Non-Shockable)|Traumatic arrest]]

==References==
<references/>

[[Category:Pulmonary]]
[[Category:Trauma]]