What's the treatment for pneumothorax?
The objective of treatment is to remove the air from the pleural space, allowing the lung to re-expand. Treatment depends upon the cause and size of the pneumothorax. A small primary spontaneous pneumothorax usually requires no treatment. It usually does not cause serious breathing problems, and the air is absorbed in several days. However, most cases of pneumothorax require hospitalization. With a smaller pneumothorax, a needle and syringe can be used to suction the air out
of the chest cavity. When the pneumothorax is large and the patient is having difficulty breathing, a chest tube is inserted through the chest wall. The tube is connected to a valve that lets the air escape from the chest cavity, but doesn’t let any air back in. Once the air is removed, the lung can re-expand. A tension pnuemothorax is a life-threatening condition. Air is quickly removed using a needle and syringe, then a chest tube is inserted to continue suctioning the air. With any treatment, the medical staff constantly monitors the patient’s breathing and heart rates, and blood oxygen levels.
People who experience recurring pneumothorax, such as those who frequently dive or fly at high altitudes, may need surgery to seal the pleural space so air cannot collect there. For people who have a pneumothorax that will not heal or a pneumothorax that has occurred twice on the same side, surgery, often using a thoracoscope, is performed to eliminate the cause of the problem. In secondary spontaneous pneumothorax with a persistent air leak into the pleural space or with a recurring pneumothorax, the underlying lung disease may make surgery hazardous. Often, the pleural space can be sealed by administering a talc mixture into the space or by giving the drug doxycycline through a chest tube that is draining air from the space.
Emergency services can generally provide oxygen therapy and positive pressure ventilating during transport to a hospital. Intubation may be required, even of a conscious patient, if the situation deteriorates. Advanced medical care and immediate evacuation are strongly indicated. In case of mountain evacuation (MEDEVAC), altitude can affect the patient. If the patient becomes short of breath while being transported, returning to the former height is important. Even a helicopter might have to alter its altitude multiple times before it can land, and reach an ambulance. Preventive measures for a non-injury related pneumothorax include stopping smoking and seeking medical attention for respiratory problems. If the pneumothorax occurs in both lungs or more than once in the same lung, surgery may be needed to prevent it from occurring again. |
