From the Guidelines
Pneumothorax pain is a medical emergency that requires immediate attention, and treatment should focus on relieving the underlying cause of the pain, which is the accumulation of air in the pleural space, as stated in the guidelines by 1.
Presentation of Pneumothorax Pain
Pneumothorax pain typically presents as sudden, sharp chest pain on the affected side that worsens with breathing or coughing, often accompanied by shortness of breath, as described in the study by 1. The pain occurs because air in the pleural space causes the lung to collapse partially or completely, irritating the sensitive pleural membranes and stretching chest wall structures.
Treatment Approach
Treatment depends on the severity of the pneumothorax, but usually includes pain management with acetaminophen (500-1000mg every 6 hours) or NSAIDs like ibuprofen (400-600mg every 6-8 hours) for mild cases, as suggested by the guidelines 1. For moderate to severe pain, opioids such as morphine (2-4mg IV) or hydrocodone (5-10mg orally every 4-6 hours) may be necessary in a hospital setting. The underlying pneumothorax requires medical attention ranging from observation for small pneumothoraces to needle aspiration or chest tube placement for larger ones, as recommended by 1.
Importance of Medical Attention
Pain typically improves as the pneumothorax resolves, which may take days to weeks depending on size and treatment approach. Anyone experiencing sudden chest pain with difficulty breathing should seek immediate medical attention as pneumothorax can be life-threatening if not properly treated, as emphasized by 1.
Key Considerations
- The development of tension pneumothorax is a life-threatening condition that requires immediate intervention, as described in the study by 1.
- The use of high-flow oxygen therapy can increase the rate of pneumothorax reabsorption, as stated in the guidelines by 1.
- Smoking cessation is crucial in preventing the recurrence of pneumothorax, as highlighted by 1.
From the Research
Pneumothorax Pain
- Pneumothorax, or air in the pleural space, can cause symptoms such as dyspnea, chest pain, tachypnea, and absent breath sounds on lung auscultation 2
- Chest pain is a common finding associated with pneumothorax, and patients with traumatic pneumothorax are typically treated with needle decompression or tube thoracostomy to relieve the pain and re-expand the lung 2, 3
- Nursing care for patients with spontaneous pneumothorax includes managing pain, preventing complications, resolving the pneumothorax, and educating the patient and family 4
Diagnosis and Management
- The diagnosis of pneumothorax can be made by physical examination findings or radiographic studies including chest radiographs, ultrasonography, or CT scanning 2, 5
- Ultrasonography is emerging as the diagnostic procedure of choice for the diagnosis and management guidance and management of pneumothoraces, if expertise is available 5
- Patients with traumatic pneumothorax are typically treated with needle decompression or tube thoracostomy, but recent literature has found that many patients can be managed conservatively via observation, or with a smaller thoracostomy such as a percutaneous pigtail catheter rather than a larger chest tube 2
Treatment Goals
- The treatment goals for pneumothorax include removing air from the pleural space, providing re-expansion of the lung, and preventing recurrence 3
- Patients who experience a spontaneous pneumothorax are at high risk for recurrence, and treatment goals also include recurrence prevention 3
- Future studies may help to identify who is greatest at risk for recurrence and direct earlier definitive management strategies, including thoracoscopic surgery, to those patients 3