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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]
Left-sided tension pneumothorax. Note the area without lung markings which is air in the pleural space. Also note the tracheal and mediastinal shift from the patient's left to right. Causes include any obstruction of blood flow to and from the heart. There are multiple, including pulmonary embolism, cardiac tamponade, and tension pneumothorax.
Obstructive shock can occur in the setting of tension pneumothorax and cardiac tamponade. These etiologies should be uncovered in the primary survey. [ 3 ] In the setting of head or neck trauma, an inadequate sympathetic response, or neurogenic shock, is a type of distributive shock that is caused by a decrease in peripheral vascular resistance ...
[27] [43] [44] The X-ray appearance of pulmonary contusion is similar to that of aspiration, [32] and the presence of hemothorax or pneumothorax may obscure the contusion on a radiograph. [25] Signs of contusion that progress after 48 hours post-injury are likely to be actually due to aspiration, pneumonia, or ARDS. [10]
Obstructive shock may be due to cardiac tamponade or a tension pneumothorax. [1] Distributive shock may be due to sepsis, anaphylaxis, injury to the upper spinal cord, or certain overdoses. [1] [4] The diagnosis is generally based on a combination of symptoms, physical examination, and laboratory tests. [2]
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 .
The affected lung "collapses" like a deflated balloon. A tension pneumothorax is a particularly severe form of this condition where the air in the pleural cavity cannot escape, so the pneumothorax keeps getting bigger until it compresses the heart and blood vessels, leading to a life-threatening situation.
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)