Rapid Identification and Emergency Management of Tension Pneumothorax: Evidence-Based Practice for Emergency, Nursing and Allied Health Professionals
Abstract
Background: Tension pneumothorax is a life-threatening condition characterized by progressive intrapleural pressure that compromises both respiratory and cardiovascular function. It is considered a “do-not-miss” diagnosis in emergency and critical care settings due to its rapid progression and reversibility with timely intervention.
Aim: To review evidence-based practices for rapid identification and emergency management of tension pneumothorax across prehospital, emergency, and critical care environments.
Methods: This narrative review synthesizes current literature on pathophysiology, clinical presentation, diagnostic strategies, and management protocols. Sources include trauma registries, critical care guidelines, and recent studies on procedural success rates and complications.
Results: Tension pneumothorax often arises from trauma, invasive procedures, or barotrauma during positive-pressure ventilation. Clinical recognition relies on signs of severe respiratory distress, hypotension, unilateral absent breath sounds, and mediastinal shift. Point-of-care ultrasound demonstrates high sensitivity (94%) and specificity (100%) for rapid diagnosis. Immediate needle decompression followed by chest tube thoracostomy remains the cornerstone of treatment, with success rates exceeding 90% when performed correctly. Delays in intervention significantly increase mortality, while early decompression markedly improves survival.
Conclusion: Rapid identification and immediate decompression are critical to preventing obstructive shock and cardiac arrest. Interprofessional coordination and adherence to evidence-based protocols enhance outcomes and reduce complications. Preventive strategies, including trauma safety, ventilator management, and patient education, further mitigate risk.
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References
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Copyright (c) 2025 Ziyad Otaywi Alanazi, Afrah Qasem Funaykhir Alshammari, Yesmin Mansour Aid Al-Azmi, Mubarakah Saeed Mohammed Alabsi, Mohammed Alabbadi, Nada Yahya Qasim Dabsh, Raghad Mohammed Sawadi, Wafaa Hamad AlSuyayfi, Aishah Mushhen Almoteri, Fatimah Mohammed Abdo Ghzzawi, Fatimah Yahya Abdo Ghzzawi, Noura Fahad Belal Alnoofal, Amal Ali Abdullah AlMahlfi
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