Tension pneumothorax is a life-threatening condition that occurs when air is trapped in the pleural space under positive pressure, displacing mediastinal structures and compromising cardiopulmonary function. It can happen secondary to trauma (traumatic pneumothorax) . When mediastinal shifts accompany it, it is called a tension pneumothorax. Tension pneumothorax is an uncommon condition with a malignant course that might result in death if left untreated. It is a severe condition that results when air is trapped in the pleural space under positive pressure, displacing mediastinal structures and compromising cardiopulmonary function. Tension pneumothorax is common in ITU-ventilated patients.
Symptoms of tension pneumothorax include chest pain, shortness of breath, rapid breathing, racing heart, followed by shock. The affected hemithorax is hyperresonant to percussion and often feels somewhat distended, tense, and poorly compressible to palpation. Tension pneumothorax should be diagnosed by clinical findings, and treatment should not be delayed pending radiographic confirmation. Treatment of tension pneumothorax is immediate needle decompression by inserting a large-bore needle into the pleural space followed by tube thoracostomy. Prompt recognition of this condition is life-saving, both outside the hospital and in modern ITUs.
