Pneumothorax types, causes, and a case study of traumatic pneumothorax

¶ … pneumothorax.We identify the two main types of Pneumothorax with its causes and possible treatments. We also analyze a case study involving a 33-year fruit vegetable merchant, who, while delivering merchandise a mini supermarket developed chest pain difficulty breathing. And then subsequently admitted to casualty and diagnosed with pneumothorax.

Pneumothorax which is defined by Light (1995) as the unprecedented entry of air into an individual's pleural space is a serious ailment. Its pathophysiology described by Combulsier in 1747 (Mohebbi and Rad, 2007). This was after realizing that the noted reduction in the pulmonary function was as a result of lung compression caused by air present in the pleural space as outlined by Sadiron et al., (1997).

Types and causes of Pneumothorax

Simple pneumothorax

This type of pneumothorax is caused by the presence of air within a victim's pleural space. It is a consequence of a blunt or a penetrating trauma with 90% of such injuries being associated with a blunt trauma subjected to the ribs. The result is a fractured rib (s) which causes a trauma to the victim's pleura (Tpub,2010).

Tension pneumothorax

Tension pneumothorax is a consequence of the accumulation of air that is under pressure in the pleural space. The condition develops whenever an injured tissue forms a one way valve and thereby allowing air to invade the pleural space and then subsequently preventing air from escaping in a natural way (Sharma and Jindal,2008). The condition then progresses rapidly to a respiratory insufficiency followed by cardiovascular collapse and then death if it is unrecognized and untreated.

The case study

The care of Mr. Colm Reilly, a 33-year-old fruit and vegetable merchant, was delivering his merchandise to a mini supermarket when he developed chest pain and difficulty breathing. He was admitted to casualty, where a Pneumothorax was diagnosed. A chest drain was inserted and admitted to casualty ward.

Discussion

Mr. Colm Reilly suffers from pneumothorax and since his case requires him to be placed under a thoracostomy tube treatment, it is important to give him a certain class of care in order to enable him to recover fully and to avoid complications associated with thoracostomy tube procedure as pointed out by Al-Tarshihi et al. (2008). The patient should always be checked for possible air leaks as well as any other breathing problems that they may be having. The tube is put in place while medication for is administered to the patient. There are usually no complication after the tube is removed (ATS, 2004).

The Orlando Regional Medical Center (2005) provided the following recommendations for patients having chest tube (CT) treatment.

Level 1

At this level the chest tube drainage should be less or equal to 2ml/kg/day or less than or equal to 200 ml/day (considering whichever is less) prior to the removal.

Level 2

The CT can be removed safely at the end-expiration or at end-inspiration. They also pointed out that the chest drain can be removed safely on suction. At this stage, a brief trial of the employed waterseal prior to the chest tube removal may be used in order to allow the leakage of the occult air to become apparent clinically and thereby reducing the need for the chest drain reinsertion as a result of recurrent pneumothorax. Such operations have however been noted to result to increased length of hospitalization.

Level 3

At this level, the non-mechanically ventilated patients do not require chest X rays (CXRs).The decision to employ CXRs is on the basis of the individual clinical situation as well as the signs and symptoms of the patients. In mechanically ventilated patients, it is necessary to obtain CXR between 1 and 3 hours after the removal of the CT.This is sufficient in positively identifying a recurrent pneumothorax.

Conclusion

Pneumothorax is a serious disease that should be avoided at all cost. Its treatment and management should be carried out with the best practices in mind in order to grant the patient a chance of recovery since the Lung is an integral organ without which the patient cannot live.