What are the symptoms of a collapsed lung. How is pneumothorax diagnosed. What treatment options are available for pneumothorax. When should you seek medical attention after a pneumothorax. How long does recovery from a collapsed lung take.

What is Pneumothorax and How Does it Occur?

Pneumothorax, commonly known as a collapsed lung, is a condition where air becomes trapped between the lung and the chest wall. This space, typically containing only lubricating fluid, expands with air due to lung damage. Pneumothorax can occur spontaneously or as a result of trauma.

Spontaneous pneumothoraces are more prevalent in certain demographics:

• Men
• Smokers
• Individuals with underlying lung diseases

The primary symptoms of pneumothorax include:

• Chest pain
• Shortness of breath
• Dry cough

Diagnosis and Treatment Options for Pneumothorax

The treatment approach for pneumothorax depends on several factors:

1. The cause (spontaneous or traumatic)
2. Presence of underlying lung disease
3. Severity of symptoms
4. Size of the pneumothorax

For large pneumothoraces or those causing significant breathing difficulties, air removal is necessary. This can be achieved through two primary methods:

• Needle aspiration: Air is sucked out using a needle. This procedure may allow patients to return home the same day.
• Chest drain insertion: A tube is placed to remove the air. This typically requires a hospital stay.

Small pneumothoraces that don’t cause breathing problems may resolve without intervention. Regardless of the treatment method, follow-up appointments are crucial for monitoring recovery.

Managing Pain Associated with Pneumothorax

Pain management is an essential aspect of pneumothorax recovery. How can patients effectively manage pain during recovery?

Paracetamol is often recommended as a first-line pain relief option. For adults, the typical dosage is two 500 mg tablets, taken four times a day. In cases of more severe pain, doctors may prescribe additional painkillers such as codeine.

Anti-inflammatory medications can be used alongside or as an alternative to paracetamol. These medications not only relieve pain but also reduce inflammation and swelling. Over-the-counter options like ibuprofen are widely available, but it’s important to follow dosage instructions carefully.

Important Considerations for Pain Management

• When taking combination medications (e.g., cocodamol or codydramol), avoid additional paracetamol to prevent accidental overdose.
• If pain persists despite using recommended dosages of simple painkillers, consult your general practitioner for stronger options.
• Always seek medical advice before starting any new pain management regimen, especially if you have other health conditions.

Recovery and Lifestyle Adjustments After Pneumothorax

Recovering from a pneumothorax requires certain lifestyle adjustments to ensure proper healing and prevent recurrence. What activities should patients avoid during recovery?

Air Travel Restrictions

Flying with an active pneumothorax is strictly prohibited due to the risk of air expansion at high altitudes, which can lead to a tension pneumothorax—a life-threatening emergency. Even after recovery, certain precautions are necessary:

• Wait at least 1 week after a clear chest X-ray before flying
• For pneumothorax caused by injury, extend the waiting period to 2 weeks
• Consider alternative transportation methods for at least a year post-recovery, as the risk of recurrence remains elevated

Scuba Diving Considerations

Scuba diving also poses risks for individuals with a history of pneumothorax:

• Those who have experienced a spontaneous pneumothorax should avoid scuba diving indefinitely
• For traumatic pneumothorax cases, diving may be possible after further medical investigation
• Professional divers may consider surgical intervention to prevent recurrence and resume their occupation

Follow-up Care and Monitoring

Proper follow-up care is crucial for ensuring complete recovery from pneumothorax. What does the follow-up process typically involve?

Patients are usually scheduled for a clinic appointment to confirm the resolution of the pneumothorax. This appointment typically includes a chest X-ray to assess lung condition.

When to Seek Urgent Medical Attention

While recovery is generally smooth, certain symptoms warrant immediate medical attention:

• Increased shortness of breath
• Worsening chest pain
• Sudden onset of dizziness or lightheadedness
• Fever or signs of infection at the site of a chest drain (if applicable)

Preventing Pneumothorax Recurrence

While not all cases of pneumothorax are preventable, certain lifestyle changes can reduce the risk of recurrence. What steps can individuals take to minimize their risk?

• Quit smoking: Smoking is a significant risk factor for spontaneous pneumothorax
• Avoid high-altitude activities: This includes mountain climbing and unpressurized air travel
• Maintain overall lung health: Regular exercise and avoiding air pollution can help strengthen lung tissue
• Follow medical advice: Adhere to treatment plans for any underlying lung conditions

Surgical Options for Recurrent Pneumothorax

For individuals experiencing repeated episodes of pneumothorax, surgical intervention may be recommended. The most common procedures include:

• Pleurodesis: This procedure involves irritating the pleural space to create scar tissue, helping the lung adhere to the chest wall
• Bullectomy: Removal of blebs or bullae (air-filled sacs) on the lung surface that may be causing recurrent air leaks
• Pleural abrasion: Mechanical irritation of the pleural surface to promote adhesion

Long-term Outlook and Quality of Life

Understanding the long-term prognosis after experiencing a pneumothorax is crucial for patients. What can individuals expect in terms of recovery and future health?

The majority of patients who experience a single episode of pneumothorax recover fully without long-term complications. However, the risk of recurrence varies depending on several factors:

• For first-time spontaneous pneumothorax: approximately 30% risk of recurrence
• Higher recurrence rates in individuals with underlying lung diseases
• Smokers have an increased risk compared to non-smokers

Impact on Daily Activities

Most patients can return to normal activities within a few weeks of recovery. However, certain considerations may apply:

• Gradual return to physical exercise, starting with low-impact activities
• Temporary avoidance of heavy lifting or strenuous activities
• Possible limitations on certain occupations or hobbies involving pressure changes (e.g., aviation, deep-sea diving)

Psychological Impact

Experiencing a pneumothorax can have psychological effects on some individuals:

• Anxiety about recurrence
• Fear of engaging in certain activities
• Stress related to lifestyle changes or medical procedures

Support groups and counseling services can be beneficial for those struggling with these concerns.

Advances in Pneumothorax Treatment and Research

Medical research continues to improve our understanding and treatment of pneumothorax. What are some recent developments in this field?

Minimally Invasive Techniques

Advancements in minimally invasive surgical techniques have improved treatment options:

• Video-assisted thoracoscopic surgery (VATS): Allows for smaller incisions and faster recovery times
• Endobronchial valve placement: A non-surgical option for treating persistent air leaks

Genetic Research

Studies into genetic factors contributing to spontaneous pneumothorax are ongoing:

• Identification of genetic markers associated with increased risk
• Potential for personalized prevention strategies based on genetic profiles

Improved Imaging Techniques

Enhanced imaging technologies are aiding in more accurate diagnosis and monitoring:

• High-resolution CT scans for detecting small blebs or bullae
• Ultrasound techniques for bedside diagnosis in emergency settings

These advancements offer hope for more effective prevention, diagnosis, and treatment of pneumothorax in the future.

Pneumothorax (Collapsed Lung) | Display Patient Information Leaflets

Date issued: December 2022 

Review date: December 2024

Ref: A-564/NB/ED/Pneumothorax (Collapsed Lung)

PDF:  Pneumothorax Collapsed Lung final December 2022.pdf [pdf] 139KB

What is a pneumothorax (new-mo-thor-ax)?

This means the lung has collapsed and there is air between the lung and the chest wall.  Normally this space is very small and only contains some lubricating fluid, but lung damage means air leaks into the space as well.

They can occur following injury or spontaneously.  Spontaneous pneumothoraces are more common in men, smokers and those with underlying lung disease.

Symptoms include chest pain, shortness of breath and a dry cough.

What is the treatment?

This depends on several factors:

• The cause of the pneumothorax (spontaneous or traumatic)

• Whether or not you have underlying lung disease

• What symptoms you have

• How big the pneumothorax is.

Generally speaking, if your pneumothorax was caused by trauma or is very large or making you short of breath then we will need to remove it either by sucking the air out through a needle or by placing a tube called a chest drain.  In the latter case you will need to stay in hospital but you may be able to go home if only a needle is required (aspiration of the pneumothorax).

If it is very small and isn’t causing breathing difficulties, then it is very likely to resolve without treatment.

Whether or not it is drained, it is important that you return to clinic in 7-10 days (you will be given an appointment before leaving the Emergency Department).

Can I take painkillers?

• Paracetamol is useful to ease pain. It is best to take it regularly for a few days or so, rather than every now and then. An adult dose is two 500 mg tablets, four times a day. A doctor may pre-scribe additional painkillers such as codeine if the pain is more severe.   If you are prescribed a combination of paracetamol and codeine (e.g., cocodamol or codydramol) then it is important not to take additional paracetamol as you will accidentally overdose

• Anti-inflammatory medication can be used with paracetamol or as an alternative. There are many types and brands. They relieve pain and reduce inflammation and swelling (often the cause of the pain). You can buy ibuprofen at pharmacies or supermarkets without a prescription. The dose varies depending on your age and other medical problems. Side-effects sometimes occur with anti-inflammatory painkillers. Ask your doctor or pharmacist for advice regarding them

If pain is not controlled by these simple painkillers, do not exceed the recommended dose but see your general practitioner to discuss the possibility of stronger painkillers.

South Tees Hospitals NHS Foundation Trust

Emergency Department and Minor Injury Unit

You have been given this information because you have been diagnosed with a pneumothorax.

A pneumothorax (collapsed lung) occurs when air is trapped between a lung and the chest wall. This can occur from an injury, such as broken ribs or a wound to the chest, but commonly occurs spontaneously. Spontaneous pneumothorax is thought to be due to a tiny tear of an outer part of the lung.

Treatment of a pneumothorax

A small pneumothorax may require no treatment.

A larger pneumothorax, that is causing shortness of breath, may be treated with a tube inserted into the chest known as a chest drain.

Recovering from a pneumothorax

Flying

If you currently have a pneumothorax you should not fly at all. This is because of the risk of the trapped air expanding and causing a tension pneumothorax (a life-threatening emergency), which can happen when the air pressure around you changes.

If you have had a recent pneumothorax you should have a chest x-ray performed prior to flying to ensure that it has resolved.

It is recommended that you wait at least 1 week after this chest x-ray before flying, or 2 weeks if your pneumothorax was caused by an injury.

The risk of recurrence does not fall significantly for at least 1 year, and is higher in those with coexisting lung disease. You may wish to consider alternative forms of transport during this time.

Scuba diving

This also increases the risk of developing a tension pneumothorax.

You should not scuba dive if you have ever had a spontaneous pneumothorax. If your occupation relies on diving, you may be suitable for an operation to prevent recurrence and allow you to dive again.

You may be able to dive if you have had a traumatic pneumothorax, but this depends on further investigation. Please discuss this with your GP.

Follow-up after a pneumothorax

You will be given a clinic appointment to ensure your pneumothorax has resolved. This will involve a chest x-ray.

You should seek urgent medical attention if any of the following occur:

• Increased shortness of breath
• Severe sharp, stabbing chest pain (pleuritic pain)

Treating pain

If needed, painkiller options include the following:

• Paracetamol is usually recommended for painful sprains or strains.

• Non-steroidal anti-inflammatory drugs (NSAIDs) relieve pain and may also limit inflammation and swelling. You can buy some types (for example, ibuprofen) at pharmacies, without a prescription either topically as a cream, or as tablets. You should check the medication advice leaflet to ensure you are safe to take these as some patients with asthma or stomach ulcers may not be able to.

If this does not help, you may need an additional stronger painkiller – such as codeine – you should discuss this with your pharmacist or GP.

For further advice and information about your condition, please choose from the following:

• ‘NHS Patient Choices’ website: www.nhs.uk
• ‘Making Lives Better’ patient website: www.patient.info
• Telephone NHS 111
• Contact your General Practitioner

Contact details

• The James Cook University Hospital, Marton Road, Middlesbrough, TS4 3BW
  Telephone: 01642 850850
• The Friarage, Northallerton, North Yorkshire, DL6 1JG
  Telephone: 01609 779911
• Redcar Primary Care Hospital, West Dyke Road, Redcar, TS10 4NW
  Telephone: 01642 511000

Patient experience

South Tees Hospitals NHS Foundation Trust would like your feedback. If you wish to share your experience about your care and treatment or on behalf of a patient, please contact The Patient Experience Department who will advise you on how best to do this.

This service is based at The James Cook University Hospital but also covers the Friarage Hospital in Northallerton, our community hospitals and community health services.

To ensure we meet your communication needs please inform the Patient Experience Department of any special requirements, for example; braille or large print.

T: 01642 835964
E: [email protected]

The James Cook University Hospital, Marton Road, Middlesbrough, TS4 3BW.

Telephone: 01642 850850

ST1614

Page published:
10/12/2021

Page last updated:
03/03/2023

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garbage bags instead of masks – British medicine on the verge of collapse Coronavirus can cause even more damage to the country than to Italy. Some hospitals are already unable to cope with the influx of patients, and due to the lack of basic protective equipment, medical staff have to use garbage bags instead of masks.

There are practically no ventilators and gloves, not enough doctors and medical staff – the British health care system is already on the verge of collapse, according to the website of the German television channel N-TV. Coronavirus can aggravate the situation and cause even more damage to the country than Italy.

First clinics refuse to see patients, nurses use garbage bags as a means of protection: the coronavirus crisis in the UK is escalating. “We know what’s coming our way – and we know it’s going to be terrible”, – British TV channel quoted a doctor from a London hospital, who wished to remain anonymous.

In his opinion, the situation in Great Britain could become even worse than in Italy. Due to a lack of staff and equipment, an unknown doctor and his colleagues will soon have to make life-and-death decisions and only provide treatment to those with the best chance of survival.

The new coronavirus has already appeared in all parts of the United Kingdom. It manifested itself especially massively in London – first of all, in the parliamentary quarter and its environs. The number of patients in hospitals is on the rise, and this is making many experts nervous. The fact is that the NHS public health service, funded mainly by taxpayers, has been underfunded for years, chronically overwhelmed and barely able to keep up. Critics argue that healthcare has simply been brought to collapse, constantly saving on it.

There are currently 4,000 ventilators in the UK for adults and only 900 for children. Thus, the country occupies one of the last places among European countries in terms of the availability of equipment per 100,000 inhabitants. According to forecasts, this number of devices will not be enough for everyone who becomes infected with the COVID-19 virus. In this situation, Prime Minister Boris Johnson was forced to turn to automakers to see if they could make medical equipment.

However, this is not the only problem associated with the epidemic, emphasizes the German TV channel. Not least because of Brexit, many health workers have long since left the country. During the winter months, when people are more likely to get the flu, the UK health care system is regularly on the brink of collapse. Critics accuse Johnson of wasting precious time with his course in the fight against coronavirus.

One London hospital has had to turn away severely ill infected patients in recent weeks due to lack of resources. Absolutely exhausted nurses in the clinic are protected from infection with the help of large blue garbage bags. “We ourselves must take the initiative into our own hands”, – one of the nurses told British journalists.