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In contrast, tension pneumothorax is a medical emergency and may be treated before imaging – especially if there is severe hypoxia, very low blood pressure, or an impaired level of consciousness. In tension pneumothorax, X-rays are sometimes required if there is doubt about the anatomical location of the pneumothorax. [16] [18]
Image shows early occurrence of tracheal deviation. Tracheal deviation is a clinical sign that results from unequal intrathoracic pressure within the chest cavity.It is most commonly associated with traumatic pneumothorax, but can be caused by a number of both acute and chronic health issues, such as pneumonectomy, atelectasis, pleural effusion, fibrothorax (pleural fibrosis), or some cancers ...
One must also consider the possibility of multiple types of shock being present. For example, a trauma patient may be hypovolemic from blood loss. This patient could also have tension pneumothorax due to trauma to the chest. [22] Vital signs in obstructive shock may show hypotension, tachycardia, and/or hypoxia.
Left tension pneumothorax with a large, well-demarcated area devoid of lung markings with tracheal deviation and movement of the heart away from the affected side. Mediastinal shift is an abnormal movement of the mediastinal structures toward one side of the chest cavity .
Signs of serious chest injuries, including penetrating trauma to the chest, which can cause a sucking chest wound; flail chest; tension pneumothorax; and cardiac tamponade; Breathing problems (like airway problems, these are also rechecked during the rapid trauma assessment by listening to breath sounds with a stethoscope)
Tension pneumothorax: a build up of air in the pleural space of the lungs causing compression and collapse of the lung. Common signs include trauma to the chest, distended neck veins, tracheal deviation (away from side of injury), and decreased breath sounds on side of injury.
Tension pneumothorax; Through increased intrathoracic pressure, venous return is impeded. [9] Pulmonary embolism is thromboembolism of the lungs, hindering oxygenation and return of blood to the heart. Aortic stenosis hinders circulation by obstructing the cardiac output.
In the emergency department the typical approach to chest pain involves ruling out the most dangerous causes: heart attack, pulmonary embolism, thoracic aortic dissection, esophageal rupture, tension pneumothorax, and cardiac tamponade. By elimination or confirmation of the most serious causes, a diagnosis of the origin of the pain may be made.