How to treat open pneumothorax? Two methods are most effective

Pneumothorax is very common in our bodies. Generally speaking, after people find out that they have open pneumothorax, they need to learn more about the treatment of open pneumothorax.

1. Emergency treatment

Open pneumothorax is easy to diagnose and, once discovered, requires immediate emergency treatment. Depending on the conditions at the scene where the patient is, self-rescue or mutual rescue can be performed to close the chest wall wound as soon as possible to convert open pneumothorax into closed pneumothorax. A large first aid kit, multiple layers of clean cloths, or thick gauze pads may be used. A large piece of Vaseline gauze or sterile plastic sheet would be more suitable. The occlusive dressing should be thick enough to avoid air leakage, but it should not be stuffed into the wound; the range should exceed the wound edge by more than 5 cm. When the patient arrives at the hospital, he or she is first given blood transfusion, fluid replacement and oxygen inhalation to correct respiratory and circulatory disorders, while further examination and clarification of the injury are also carried out. After the general condition improves, debridement should be performed under endotracheal intubation anesthesia and closed chest drainage should be placed as soon as possible. If there is severe damage to intrathoracic organs such as the lungs, bronchi, heart, and blood vessels, a thoracotomy should be performed as soon as possible.

2. Closed chest drainage

Closed chest drainage is the simplest and most effective treatment method and an effective measure to save the patient's life. It is not only beneficial to the re-expansion of the lungs, improving the patient's breathing and circulation conditions, but also helpful for observing the presence and speed of active bleeding and air leakage in the chest cavity, and provides a basis for whether surgical treatment is necessary.

(1) Indications: Acute empyema, chest trauma, major lung and other thoracic surgery, and tension pneumothorax.

(2) Contraindications: Tuberculous empyema.

(3) Precautions: Keep the drainage tube unobstructed and avoid compression or twisting. The drainage volume, its nature and changes were recorded daily. Help the patient sit up and change position every day to ensure full drainage. If it is an acute empyema, secretions should be obtained during surgery for routine examination, bacterial culture and drug sensitivity testing. If it is a tension pneumothorax, a tube can be placed in the 2nd anterior intercostal space of the midclavicular line, the 4th or 5th intercostal space of the anterior axillary line or the midaxillary line on the affected side. Postoperative precautions are the same as those for closed chest drainage with cannula. Regular chest X-rays are performed to monitor lung expansion and pleural effusion.

(4) Cure criteria: symptoms disappear. Chest wall wound healing. X-ray examination: gas disappeared, no effusion, lungs expanded well.