Okay.
Let s talk Pneumo and Hemothorax.
Okay, when we get into this, we re talking about air or blood within the pleural space.
Cause, we have our lung, and our lung is surrounded by what s called the pleura, and the pleura
is a little sac that allows lung to move in an out so that we can breathe comfortably.
Now, what can happen with pneumothorax is that air can get inside this space, it can
actually shrink the lung, as air escapes in here, and it s not able to get out.
With hemothorax, this can fill with blood and it can push the lung in because this pleura
is an enclosed cavity and that air, that blood cannot get out.
Okay, so that s what a pneumothorax and hemothorax is.
So, there s a couple of different kinds of pneumothorax. Again, pneumothorax means air.
Okay. Spontaneous pneumothorax is that, on this lung space here, you can get little blebs,
B-L-E-B-S, and those little blebs can actually rupture and cause air to go out into the pleural
space. That air builds up pressure will cause the lung to go down. Those blebs can be spontaneous,
that can also be caused from emphysema or asthma. Okay. So, those would be primary and
secondary spontaneous pneumothorax. Tension pneumothorax, on the other hand, is when that
pneumothorax, that air in that space become so great, that it actually causes the mediastanum
to shift as it s pushing all these space over, this whole area shifts. Our trachea is gonna
be deviate towards the unaffected side, it s going to actually cause a lot of pressure
in the heart which is going to affect venous return and we re gonna see a decrease in blood
pressure. So, that s what s gonna happen when it becomes a tension pneumothorax. Shift in
mediastanum, disruption of venous return to the heart. And this is an absolute medical
emergency. Okay. Hemothorax, on the other hand, as we said, is the blood accumulation
in the pleural space. Now, this can also happen for trauma, from trauma, it could also happen
iatrogenic, meaning, in the hospital, from surgical procedures and things like that.
So, assessment. First, we re gonna see is dyspnea, decreased breath sounds on affected
side, we re gonna have unequal chest expansion, of course because half of our lung fields
are not going to be expanding as air is not entering or unable to enter. We re gonna see
tracheal deviation on tension pneumothorax towards the unaffected side. Okay, so our
trachea is going to deviate towards the good lung because this area here is all pressed
over. Okay, we re gonna hear dullness on precussion on the affected side in hemothorax, with all
this blood in here, it s gonna sound really dull percussed and we re gonna have hyperresonance
on pneumothorax. Okay, that affected side is gonna be filled with air. When we percuss,
that s just gonna sound hollow. Some things we can do if the pneumothorax is significant,
we can put a chest tube in and that can drain out the air. We put that in a water seal.
If the hemothorax, the way we get rid of hemothorax is we actually do what is called a thoracentesis.
The patient lies down on the table, okay, this will be their head, they lie down, the
physician puts a large bore needle in and we can suction out all of that blood. Okay,
so that s the kind of a treatment for tension pneumo and hemothorax. Again, chest tube would
only be kinda needed in a very significant pneumothorax, tension pneumothorax.
Okay, guys, that is the pneumo and hemothorax. Thanks for listening and be sure to subscribe
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