Diagnosis and treatment of pneumothorax

Content

  • Diagnosis of pneumothorax
  • Emergency aid for pneumothorax



  • Diagnostics

    pneumothorax

    Recognition pneumothorax easy
    Based on acute pain in his side, increasing shortness of breath, shock symptoms,
    associated with rapid inflow of air into the pleural cavity,
    accompanied by a variety of pulses with the pleura, lung, small vessels
    circle, the pericardium, the vena cava, the aorta.


    Left-sided pneumothorax due to acute pain in the
    the apex of the heart, breathlessness, collapse mistaken for myocardial infarction. at
    right-sided pneumothorax in connection with the disappearance of liver
    dullness, collapse can be thought of gastric ulcer perforation,
    12 duodenal ulcer. Heart offset in both cases can
    accompanied by ECG changes similar to those that
    observed in myocardial. However, the pain of spontaneous pneumothorax is not
    irradiate either the left or to the right upper limb or neck,
    there is a unilateral absence of breath and other symptoms of pneumothorax. Because of the pain in the chest, breathlessness, collapse of embolism (massive)
    pulmonary artery can be mixed with suffocating pneumothorax.
    Expansion of the heart to the right jugular vein, the expansion of the lung
    artery, the typical symptoms of pneumothorax allow stetakusticheskie
    Correct mistake. Acute respiratory failure (in the background
    chronic respiratory failure) leads to misdiagnosis
    spontaneous pneumothorax when pronounced emphysema as well as in
    severe asthma attack. Medical history, typical symptoms for
    asthma and emphysema usually allow to establish the correct
    diagnosis.


    X-ray examination in difficult cases to solve
    diagnostic problem: the disappearance of a pulmonary drawing on the patient
    side, pre-loaded to the root of the lung, in the case of adhesions - a modified circuit
    his, displacement of the heart, the presence of effusion from the horizontal level.



    First aid at pneumothorax

    Diagnosis and treatment of pneumothoraxThe patient in the early hours necessary to provide urgent
    help, since he is in mortal danger. Its stack in
    bed with lofty position of the body (the patients themselves take
    Half-upright position); injected under the skin to inhibit morphine
    excitation potential cough; against hypoxemia applied oxygen,
    best through nasal catheter connected to the oxygen
    cylinder where oxygen reducer adjusts the flow rate. To combat
    acute cardio-vascular and respiratory failure are shown
    Intravenous infusion of 1% novocaine solution (5-10 ml slowly over
    3-5 minutes) or intravenous Sol. Papaverini 2% -2 ml. injections
    novocaine and papaverine can be repeated after 4 hours. Special
    vagosympathetic effective blockade on the neck (to eliminate the flow
    pathological impulses from the pleura and other organs), executable in
    hospital.

    Severe respiratory disorders in the closed and
    especially valve pneumothorax eliminated by reducing
    intrapleural pressure. For this purpose, produce a puncture (in
    5-6 intercostal space-axillary line at the upper edge
    underlying ribs) any thick needle, be sure to put on her
    rubber tube length of 1 m. The free end of the tube is immersed in the
    1-2 cm in a container of water. The needle is extracted from the pleural cavity only after
    how to stop passage of air bubbles through the water. A place
    puncture closed sterile sticker with collodion. If the
    pleural puncture again begins to grow short of breath, you must
    apply steady drainage under water. In this case the needle cannula
    necessary to fix using leucoplasts and lead to patients
    observation.


    In all cases, pneumothorax to prevent and treat infection
    pleural necessary to use penicillin and streptomycin in large
    doses (1000000 units -. 1 500 000 units of penicillin, 1 000000 units..
    streptomycin per day).


    However, this treatment often relapses occur, and the presence of
    open fistula associated with the risk of pneumothorax in transition
    chronic. In the context of a well-organized hospital but
    thorough radiological investigation is needed plevroskopiya,
    which makes it possible to detect the presence of pleural bands,
    causing the gaping holes in the pleura. In these cases, the illustrated
    crossing them, which certainly can be successfully carried out
    TB specialist surgeon.

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