Tension pneumothorax is the accumulation of air under pressure in the pleural space. This condition develops when injured tissue forms a 1-way valve, allowing air to enter the pleural space and preventing the air from escaping naturally. Arising from numerous causes, this condition rapidly progresses to respiratory insufficiency, cardiovascular collapse, and, ultimately, death if unrecognized and untreated. Favorable patient outcomes require urgent diagnosis and immediate management. | Tension pneumothorax Tension pneumothorax is the accumulation of air under pressure in the pleural space. This condition develops when injured tissue forms a 1-way valve allowing air to enter the pleural space and preventing the air from escaping naturally. Arising from numerous causes this condition rapidly progresses to respiratory insufficiency cardiovascular collapse and ultimately death if unrecognized and untreated. Favorable patient outcomes require urgent diagnosis and immediate management. Tension pneumothorax is a clinical diagnosis that now is more readily recognized because of improvements in emergency medical services EMS and the widespread use of chest x-rays see image below . This picture shows a chest radiograph with 2 abnormalities 1 tension pneumothorax and 2 potentially life-saving intervention delayed while waiting for x-ray results. Tension pneumothorax is a clinical diagnosis requiring emergent needle decompression and therapy should never be delayed for x-ray confirmation. Problem Air trapped in the pleural cavity and causing shifts of the intrathoracic structure is a life-threatening emergency. Promptly recognizing this condition saves lives both outside the hospital and in a modern intensive care unit ICU . Because tension pneumothorax occurs infrequently and has potentially devastating effects a high index of suspicion and knowledge of basic emergency thoracic decompression are important for all healthcare personnel. Although some authors are now questioning the pathophysiology of tension pneumothorax no animal models or randomized prospective trials have provided any evidence that our understanding of the cause effects and treatment of the disease should be changed. Presentation Clinical interpretation of the presenting signs and symptoms of a tension pneumothorax is crucial for diagnosing and treating the condition. Early findings o Chest pain o Dyspnea o Anxiety o Tachypnea o Tachycardia o Hyperresonance of the chest wall on the .
