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STROKE TENSION

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									          TENSION PNEUMOTHORAX

PATHOPHYSIOLOGY
     Pneumothorax is a condition in which air enters the normally
     closed space between the visceral and parietal pleura,
     causing the collapse of lung tissue. The lung is dependent on
     a “relative negative pressure” within the pleural space to
     stay expanded. If a wound permits air to enter the pleural
     space, it may also act as a one-way valve, producing a
     condition called tension pneumothorax. Tension
     pneumothorax is a progressive pneumothorax that enlarges,
     builds pressure, and begins to infringe upon the function of
     the opposite lung and the circulatory system.

SIGNS/SYMPTOMS OF TENSION PNEUMOTHORAX
 Dyspnea
 Diminished or absent breath sounds
 Tracheal shift away from the side of injury
 Distended neck veins
 Apprehension, agitation, and/or decreased Level of
  consciousness
 Cyanosis
 Signs and symptoms of shock
 Subcutaneous emphysema
                                TREATMENT GOALS

EMT BASIC
    Perform Initial Assessment
    DO NOT DELAY TRANSPORT
    LOAD AND GO
    ALS intercept
    High flow oxygen
    Seal open chest wounds
    If you have sealed a sucking chest wound – unseal it to relieve the
     pressure




EMT INTERMEDIATE
 I.V. (18G or larger), two started enroute to A.L.S.

EMT PARAMEDIC
   Needle decompression in one of two possible sites. #1
    Second intercostal space – midclavicular line or #2 Fifth
    intercostal space – midaxillary line

HOSPITAL
    Chest tube
    Surgical repair of lung/chest wall

                                                   Sources:
1.   American College of Emergency Physician’s Paramedic Field Care Textbook. 1997
2.   Emergency Medicine – A Comprehensive Study Guide, ACEP 5th edition, 1999
3.   Brady’s Paramedic Emergency Care, 3rd edition. 1997

                                              Revised 12/1999

								
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