{"id":5284,"date":"2020-09-08T09:38:57","date_gmt":"2020-09-08T13:38:57","guid":{"rendered":"https:\/\/todaysveterinarynurse.com\/?post_type=articles&p=5284"},"modified":"2022-07-28T14:23:28","modified_gmt":"2022-07-28T14:23:28","slug":"nursing-a-patient-with-a-traumatic-pneumothorax","status":"publish","type":"post","link":"https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/emergency-medicine-critical-care\/nursing-a-patient-with-a-traumatic-pneumothorax\/","title":{"rendered":"Nursing a Patient With a Traumatic Pneumothorax"},"content":{"rendered":"

A <\/span>pneumothorax<\/i> is an emergent<\/span> condition<\/span> caused by air leaking into the pleural space, thereby restricting lung expansion and eventually causing lung collapse. Although there are several potential etiologies of air accumulation in the pleural space, the most common is accidental blunt or penetrating trauma.1<\/sup> When a pneumothorax is related to trauma, it is categorized as a traumatic pneumothorax. Veterinary nurses and technicians play an important role in the nursing management of traumatic pneumothorax patients by performing patient assessments, performing diagnostic tests (e.g., laboratory analysis, imaging), recognizing changes in patient condition, and providing general nursing care.<\/span><\/p>\n

Incidence Of Traumatic Pneumothorax<\/h2>\n

Studies have looked at causes of trauma, frequency of injuries to anatomic regions (<\/span>TABLE 1<\/b><\/span>),2<\/sup> and the type of injuries specific to an anatomic region in dogs and cats. One study of 267 dogs involved in motor vehicle accidents determined that 104 (39%) had thoracic trauma; of those, 52 (50%) had a pneumothorax.3<\/sup> Another study of severe blunt trauma in 235 dogs determined that 91.1% of the dogs were involved in a motor vehicle accident.4<\/sup> In this study, 72.3% and 20.4% of the dogs suffered chest and abdomen\/chest trauma, respectively. Chest injuries included pneumothorax in 47% of all patients.<\/span><\/p>\n

\"TVN_Fall20_CaninePneumothorax_Table1\"<\/a><\/p>\n

Anatomy<\/h2>\n

The pleural space is the narrow space between the membranes that surround and protect the lungs, known as the visceral (adjacent to the lung) and parietal (adjacent to the thoracic wall) pleura. The function of the pleura and the pleural space is to assist in breathing by helping maintain the relationship between the lungs and the thoracic wall during inspiration and expiration, as well as eliminating friction that would otherwise be created against the surface of the lungs. Normally, the pleural space contains only a small amount of lubricating fluid and is sealed off from the rest of the thoracic cavity to maintain a subatmospheric pressure. If air is introduced into the pleural space, this pressure is lost and the pleura separate, impairing ventilation and, subsequently, oxygenation.<\/span><\/p>\n

Pathogenesis<\/h2>\n

Air can enter the pleural space as a result of an internal rupture (of the lung, trachea, or pulmonary parenchyma bleb) or an open wound or puncture in the chest wall. Pneumothoraxes resulting from internal tears are categorized as closed<\/i>; those due to penetration and disruption of the integrity of the chest wall are considered open<\/i>. A traumatic pneumothorax may be closed or open. <\/span><\/p>\n

Open pneumothoraxes are caused by external trauma (e.g., gunshot, bite wound). There are several potential mechanisms for the development of a closed pneumothorax in trauma patients: <\/span><\/p>\n