Tension pneumothorax

Tension pneumothorax is a medical condition characterized by the accumulation of air or gas in the pleural space of the chest, which can lead to lung collapse and significant difficulty breathing. Unlike simple pneumothorax, tension pneumothorax has the effect of a one-way valve, which allows air to enter the pleural space during inhalation, but not its exit during exhalation. This causes pressure in the chest cavity to increase and can be life-threatening if left untreated.

Here are some key points about tension pneumothorax:

  1. Causes: Tension pneumothorax is usually caused by trauma, such as a rib fracture, puncture wound, or lung injury. It can also happen spontaneously, especially in people with underlying lung diseases such as chronic obstructive pulmonary disease (COPD) or asthma.
  2. Symptoms: Symptoms of tension pneumothorax can vary, but common signs include sudden onset of chest pain, difficulty breathing, rapid and shallow breathing, rapid heart rate, cyanosis (a bluish discoloration of the skin), and a sense of impending doom. The affected person may also experience reduced or absent breath sounds on the affected side of the chest.
  3. Diagnosis: A tension pneumothorax is a medical emergency that requires prompt diagnosis and treatment. Doctors may perform a physical exam, listen to breath sounds with a stethoscope, and order imaging tests such as a chest X-ray or computed tomography (CT) scan to confirm the diagnosis.
  4. Treatment: It is urgent to reduce the pressure and restore normal breathing. The basic treatment for tension pneumothorax is needle decompression or placement of a chest tube. In needle decompression, a large needle is inserted into the chest cavity to release air. A chest tube may subsequently be placed to drain the air and re-expand the collapsed lung. In more severe cases, an emergency operation called a thoracotomy may be needed to repair the lung.
  5. Follow-up care: After initial treatment, people with tension pneumothorax will usually be closely monitored in a medical facility. They can receive supplemental oxygen, pain therapy, and appropriate respiratory support if needed. Additional imaging tests and examinations will be performed to ensure proper lung expansion and to assess for possible complications.

If you suspect that someone may have tension pneumothorax, it is important to seek immediate medical attention by calling 911 or going to the nearest emergency room. Early recognition and prompt intervention can significantly improve outcomes for people with this condition.

Tension pneumothorax is characterized by the accumulation of air in the pleural space (without the possibility of exit), which leads to increased intrathoracic pressure on the injured side of the chest. The lungs collapse due to the accumulation of air and the inability to escape.


  • Dyspnoea
  • Anxiety
  • Tachypnea
  • Weakened or absent breath sounds on the affected side
  • Hypersonant sound when hitting the affected side
  • Hypotension
  • Swollen neck veins
  • Deviation of the trachea
  • If the patient is intubated, the development of a tension pneumothorax may lead to resistance during inflation.


  • Respiratory insufficiency and cyanosis
  • Loss of radial pulse
  • Reduced level of consciousness

The presence of tension pneumothorax should be confirmed by at least two factors before decompression of the injured side.


  • Bleeding from injuries to blood vessels along the lower ribs
  • If not already present, needle insertion may lead to the development of a pneumothorax
  • Partial tearing of the lung
  • Infection


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