DIANOGSIS:
History:
o Ipsilateral chest or shoulder pain, usually of abrupt onset.
o Dyspnea.
o Recent trama.
o Mechanical ventilation.
• General appearance
o Diaphoretic
o Splinting chest wall to relieve pleuritic pain
o Cyanotic (with tension pneumothoraces)
• Vital signs
o Tachypnea
o Tachycardia - If faster than 135 beats per minute (bpm), tension pneumothorax is likely
o Distant or absent breath sounds
o Hyperresonance on percussion
o Decreased tactile fremitus
Tension pneumothorax
o Pulsus paradoxus
o Hypotension
o Asymmetric lung expansion - Mediastinal and tracheal shift to the contralateral side with a large tension pneumothorax
Treatment:
 Treatment depends on cause, size, degree of physiologic derangement and the underlying disease.
 Tension pneumothorax must be treated as a medical emergency. If the tension in the pleural space is not relieved, the patient is likely to die from inadequate cardiac output or marked hypoxemia.
A large-bore needle should be inserted into the pleural space through the second anterior intercostal space. The needle should be left in place until a thoracostomy tube can be inserted.

Readmore Ycantho.