SPONTANEOUS PNEUMOTHORAX Dr. Yewande Olupitan Senior House Officer Emergency Medicine.

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SPONTANEOUS PNEUMOTHORAX Dr. Yewande Olupitan Senior House Officer Emergency Medicine

Transcript of SPONTANEOUS PNEUMOTHORAX Dr. Yewande Olupitan Senior House Officer Emergency Medicine.

Page 1: SPONTANEOUS PNEUMOTHORAX Dr. Yewande Olupitan Senior House Officer Emergency Medicine.

SPONTANEOUS PNEUMOTHORAX

Dr. Yewande OlupitanSenior House Officer Emergency Medicine

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WHAT?The presence of air or gas within the pleural cavity which can impair oxygenation and/or ventilation.

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WHY?Ruptured Subpleural Bullae(Primary)

Secondary causes include:

Asthma

COPD

Tuberculosis

Malignancy

Bronchiectasis/Cystic Fibrosis

Idiopathic pulmonary Fibrosis

Sarcoidosis

Pneumocystis carinii pneumonia

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HOW COMMON?7.4 per 100,000 /year USA

37 per 100,000/year UK

Incidence substantially lower in Females

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WHO’S AFFECTED?

Tall, thin MALES

Smokers

Marfan’s syndrome

Homocystinuria

Family history

Thoracic Endometriosis

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CLINICAL PICTUREPleuritic chest pain-severity of which varies depending on degree of lung collapse.

Acute Shortness of Breath

Normal physical examination

Tachypnea

Asymetric chest expansion

Reduced breath sounds

Tachycardia

Hypoxia

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FINDINGSArterial Blood Gas:

Hypoxia

Acidemia

Hypercarbia

Depending on degree of Cardiopulmonary compromise

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RADIOLOGIC FINDINGSChest Xray is Key!

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MANAGEMENTBRITISH THORACIC SOCIETY GUIDELINES

2010

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OUTCOMEObserve &Discharge with ED review with CXR 2wks

Secondary pneumothorax successfully treated with aspiration-Admit under Inpatient Medical TOC

Discharge advcice against flying,diving

KIV Recurrence: 25%-50% in first year

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Thanks for Listening

QUESTIONS, QUERIES,CLARIFICATIONS….

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REFERENCESED Guidance Notes July 2014

www.brit-thoracic.org.uk

www.nejm.org

www.uptodate.com

www.emedicine.com