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Sat, 23 Feb 2002 11:05:32 +0000

> 
>> In T.P. the lung will not re-inflate once the tension has been relieved.
> 
> **Sure it will...that's the whole reason for pleural decompression!! Until
> they can buy a chest tube it's a partial fix.
> 
Have to disagree. I don't think that the lung will re-inflate. The needle
only removes high pressure air, and converts a tension pneumothorax into a
simple pneumothorax (still with a collapsed lung). The lung will only
re-expand when the low pressure air in the pleural space is removed (using a
wider bore tube with some sort of one way valve; flutter, Heimlich or under
water seal).
The dramatic improvement see with a needle is probably due to the removal of
the haemodynamic effects (see Avi's comments) and allowing the other lung to
work properly. Patients without pre-existing chest disease will not be
hypoxic even if they are only breathing on one lung.
Tim.

-- 
Mr. T J Coats
Senior Lecturer in Accident, Emergency and Pre-Hospital Care
Bart's and the Royal London School of Medicine

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