Pneumothorax is a dangerous condition that occurs when air enters the pleural cavity, which can cause compression of the lung and respiratory failure. This pathology requires immediate medical attention, as its consequences can be fatal. That is, it is a condition when air enters the pleural cavity (the space between the lungs and the chest wall), which disrupts the normal breathing process and can lead to the collapse of the lung.
Main causes of pneumothorax
- Traumatic pneumothorax – occurs due to chest injuries (e.g., bullet, knife, or shrapnel injuries), as well as blunt trauma that ruptures lung tissue.
- Spontaneous pneumothorax – occurs without apparent trauma, often in tall, thin people or due to lung disease (e.g., COPD, tuberculosis, cystic fibrosis).
- Iatrogenic pneumothorax – caused by medical procedures (e.g., pleural puncture, subclavian vein catheterization).
Why is pneumothorax relevant to tactical medicine?
In combat, traumatic pneumothorax is a common threat due to gunshot and shrapnel wounds. If not recognized and treated promptly, it can develop into tension pneumothorax, a critical condition characterized by increased pressure in the thoracic cavity, mediastinal displacement, and cardiac arrest.
First aid for pneumothorax: occlusive dressings and decompression needle
An occlusive dressing is a special airtight dressing that is applied to open wounds of the chest to prevent further air from entering the pleural cavity.
When to use?
- In case of open pneumothorax (a wound in the chest through which air is sucked in).
- If there are signs of difficulty breathing and a suspicion of a penetrating lung injury.
- If the wound is through - you need to apply two dressings (on the inlet and outlet holes).
Types of dressings
- Without a valve - they simply seal the wound. You need to monitor the condition of the victim.
- With a valve - they have a membrane that allows air to escape, but does not let it back in.
How to apply it correctly?
- Inspect the wound - act quickly.
- Clean the skin around the wound.
- Apply the dressing - press it tightly to the wound.
- Check the exit wound - close with a second dressing, if necessary.
- Monitor the condition of the victim.
Thus, occlusive dressings:
- Are used to seal an open pneumothorax.
- Are applied to the wound, creating a barrier to air.
- Have a valve that allows air to escape from the chest cavity.
Decompression needle: use in pneumothorax
A decompression needle is a long, thick needle (usually 14G, 8–10 cm) that is inserted into the chest cavity to release air in tension pneumothorax.
When to use?
If the condition worsens after applying an occlusive dressing. Signs:
- Increasing shortness of breath.
- Distended jugular veins.
- Absence of breathing on one side.
- Tachycardia, decreased blood pressure.
- Symptoms of shock.
How to insert a decompression needle correctly?
- Primary site: 2nd intercostal space in the midclavicular line.
- Alternative: 5th intercostal space in the anterior axillary line.
Procedure:
- Examine the casualty – confirm symptoms.
- Prepare a needle – sterile, with a catheter.
- Find the insertion site.
- Inject perpendicularly – until air escapes.
- Leave the catheter – remove the needle.
- Monitor the condition - repeat or evacuate if necessary.
Symptoms of pneumothorax
- Sudden sharp chest pain.
- Shortness of breath, difficulty breathing.
- Bluish skin.
- Rapid heartbeat.
- Low blood pressure (in severe cases).
If these symptoms appear, consult a doctor immediately!
Treatment of pneumothorax
Pneumothorax Treatment methods depend on the severity:
- Expectant tactics - the air can be sucked out on its own.
- Pleural puncture - a decompression needle is used.
- Pleural drainage - installation of a drain to remove air.
- Surgical treatment - for relapses or complications.
Early diagnosis and proper treatment are the key to saving life.
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