Immediate Questions

A. What are the vital signs? Tachycardia, tachypnea, and hypertension may reflect compensatory mechanisms. Negative intrapleural pressure and blood vessel torsion from mediastinal

shifts leads to reduced venous return to the right atrium and hypotension.

B. Is patient cyanotic? Cyanosis indicates severe hypoxemia and acute respiratory distress.

C. Can patient communicate? Inability to communicate indicates airway obstruction and impending acute respiratory failure.

D. What was patient doing immediately prior to onset of chest pain? Pneumothorax can occur at rest as well as with activities, including chest wall trauma (eg, ball injury, wrestling, automobile accident, air bag deployment), blunt abdominal trauma, wheezing, coughing, laughing, crying, and injection of drugs into the internal jugular or subclavian veins.

E Does patient have a history of chest pain? The chest pain of pneumothorax may be recurrent and repetitive in quality and location.

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