Tension pneumothorax facts for kids

A tension pneumothorax is a serious medical problem where air builds up inside your chest. This can cause one or both of your lungs to collapse. When a lung collapses, it's very hard to breathe. The extra air in the chest also pushes on your heart and other important body parts. If it's not treated quickly, a tension pneumothorax can be deadly.

How a Tension Pneumothorax Happens

A tension pneumothorax usually happens because of an injury to the chest. For example, a stab wound or a gunshot wound can make a hole in the chest. Air can then get sucked in through this hole. This air starts to build up inside the chest, pushing on the lungs. If the injury also makes a hole in the lung itself, air can leak out of the lung. This air also builds up in the chest. When enough air pushes on the lung, it will collapse.

Sometimes, a tension pneumothorax can happen from other chest injuries, like from a car accident or a bad fall. In these cases, there might not be an open hole in the chest. But inside the body, a person might be bleeding a lot. Instead of air, blood builds up in the chest. This blood pushes on the lung and makes it collapse. When this happens with blood, it's called a hemothorax.

What Happens as it Gets Worse

Once a person's lung collapses, they will have trouble breathing. As more air or blood keeps building up in the chest, the person's symptoms will get worse and worse.

The air or blood in the chest will push against and squeeze the heart. This can cause very serious problems. If the heart is squeezed too much, it can't fill with blood properly. This means it won't have enough blood to pump to the rest of the body. Every part of your body needs blood to survive. If the heart can't pump enough blood, other parts of the body can start to get damaged.

The pressure in the chest can also squeeze the vena cavae. These are big veins that bring blood from your body back to your heart. If the vena cavae are squeezed too tightly, blood won't be able to get into the heart. This means the heart won't have enough blood to pump to the lungs or the rest of the body.

If a person bleeds a lot into their chest, they can go into shock and die from losing too much blood. If enough pressure builds up in the chest, the other lung can collapse too. If both lungs have collapsed, the person won't be able to breathe at all.

Signs and Symptoms

A tension pneumothorax causes several other signs that doctors look for. For example:

• Mediastinal shift: This means that everything in the mediastinum – the space between the heart and the lungs – gets pushed to one side by the air or blood. A medical professional might see that the trachea (windpipe) is pushed to one side. In medicine, this is called tracheal deviation.
• Jugular vein distention (JVD): This means the large veins in the neck will look big and full of blood. This happens because blood can't get to the heart through the vena cavae, which are being squeezed. So, the blood backs up into the neck veins (the jugular veins).
• Bulging intercostals: The muscles between the ribs might bulge out because of the pressure inside the chest.
• Unilateral breath sounds: When a medical professional listens to the lungs with a stethoscope, they will only hear breath sounds (the sounds of air moving) on one side. They won't hear anything on the side where the lung has collapsed.

Emergency Treatment

A tension pneumothorax always needs emergency medical help right away. If someone might have a tension pneumothorax (or any bad chest injury), you should call 911 or another emergency telephone number immediately. The emergency medical dispatcher can tell you how to help the person until an ambulance arrives.

Emergency medical technicians (EMTs) or paramedics might give these treatments:

• Give the person oxygen to help them breathe.
• Put something occlusive (meaning it seals tightly) over any hole in the chest. This stops more air from getting in. Examples include plastic wrap, aluminum foil, or special sticky bandages called occlusive dressings. These help keep more pressure from building up in the chest.
• Put a hollow needle into the person's chest so the trapped air can escape. This is called a needle decompression.

At the hospital, a patient with a tension pneumothorax will usually get a chest tube. This is a tube placed into the chest to let air or blood drain out, so it doesn't build up inside. If the person has bled a lot into their chest, they might also need blood transfusions.

Related pages

• Pneumothorax
• Lungs

Images for kids

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  A schematic drawing of a bulla and a bleb, two lung abnormalities that may rupture and lead to pneumothorax.

See also

In Spanish: Neumotórax para niños