Pneumothorax

A pneumothorax is defined as air in the pleural space. It can be spontaneous, occur as the result of trauma, or be iatrogenic. Patients with a pneumothorax commonly present with pleuritic chest pain on the affected side and/or breathlessness. Younger patients often have minimal breathlessness although in secondary pneumothorax breathlessness may be increased. A pneumothorax will reduce the compliance of the lungs and so the lungs will become stiffer. Because of reduced compliance in the affected lung greater pressure needs to be generated during inspiration to move the same volume of air into the lungs. As a result, breathing will become more of an effort and the sensation of breathlessness will be increased. The patient may also have pleuritic chest pain from inflammation of the pleura, generally due to bleeding, and heightened by attempts to inflate the affected lung. This chapter covers the incidence, risk factors, features, and investigations of the condition, different management options and prognosis, and different aspects of nursing care. Practical care of chest drains and management of the pregnant patient is also covered.