Accidents are often unpredictable, and some medical emergencies require the highest level of attention, even from experienced first responders. One such life-threatening condition is tension pneumothorax.

Understanding this condition is crucial for handling emergencies effectively. Let’s take a closer look at what tension pneumothorax is and why it is so dangerous.

What Is Tension Pneumothorax?

Tension pneumothorax is an extremely dangerous condition. To put it simply, the pleural cavity is a sealed space surrounding the lungs.

Under normal circumstances, this cavity contains a small amount of fluid that lubricates the lungs, allowing them to move smoothly during breathing. However, when tension pneumothorax occurs, air enters the pleural cavity but cannot escape.

It works like a balloon that keeps inflating without a way to release air. As more air builds up, pressure inside the chest rises, leading to serious complications.

How Does It Develop?

Tension pneumothorax usually results from trauma or medical procedures.

• Trauma is one of the most common causes. A penetrating injury, such as a stab wound to the chest, allows air from the outside to enter the pleural cavity. A rib fracture can also puncture lung tissue, allowing air to leak from the lung into the pleural space. In both cases, a one-way valve mechanism forms, where air enters but cannot exit, leading to increasing pressure.
• Medical procedures can also cause tension pneumothorax. For example, improper settings on a mechanical ventilator may create excessive pressure, leading to alveolar rupture and air leakage into the pleural cavity. Central venous catheter placement is another potential cause—if the catheter accidentally punctures a blood vessel and the pleura, air can enter the pleural space. As air accumulates, pressure inside the chest rises, compressing the lung and causing it to collapse.

What Are the Symptoms?

Tension pneumothorax symptoms worsen as the condition progresses.

• Early signs include sharp chest pain, often described as stabbing or piercing. Breathing becomes rapid as the body tries to compensate for reduced oxygen levels. Patients may also feel anxious or restless due to discomfort and difficulty breathing.
• As the condition worsens, breathing becomes increasingly difficult, and cyanosis (bluish discoloration of the lips and fingernails) may appear due to oxygen deprivation. Blood pressure starts to drop, signaling that the heart’s ability to pump blood is being affected.
• In severe cases, the trachea may shift to one side due to uneven pressure in the chest. Distended neck veins become visible as blood struggles to return to the heart. If not treated immediately, the patient may go into cardiac arrest, which can be fatal.

What Are the Risks?

Tension pneumothorax mainly affects the lungs, heart, and circulation.

• Lung damage occurs as pressure in the chest increases, causing alveoli to collapse. The alveoli play a key role in gas exchange, and their collapse prevents oxygen from entering the bloodstream and carbon dioxide from leaving the body. As a result, organ function deteriorates due to insufficient oxygen supply.
• Cardiovascular impact is also severe. Rising chest pressure restricts venous blood return to the heart. Since veins transport blood back to the heart, this blockage reduces blood filling in the heart’s chambers, decreasing cardiac output. With less blood being pumped to the body, blood pressure drops, leading to shock and potential organ failure.

Conclusion

Tension pneumothorax is a life-threatening emergency that requires immediate recognition and intervention. Understanding its symptoms and risks can help individuals stay calm during emergencies and possibly save lives.

Everyone should take the time to learn essential first aid skills to protect their own health and that of others.