Collapsed Lung: Injury-Related

What is a collapsed lung?

Collapsed lung is a term used to refer to pneumothorax, a potentially life-threatening condition. A pneumothorax happens when air enters the space between your rib cage and one of your lungs. The air causes part or all of the lung to collapse. It is then hard to breathe normally and your body gets less oxygen.

How does it occur?

A chest injury can cause collapsed lung. Car accidents are the most common cause of chest injuries that cause collapsed lung. A third of these injuries cause death from lung damage.

Collapsed lung can be caused by a penetrating injury, such as a stab or bullet wound. It also can be caused by nonpenetrating injuries, such as fractured ribs, electric shock, or near drowning.

Tension pneumothorax is a more serious condition in which the chest keeps filling with air and the air has no way to escape. It causes a very high pressure in the chest. A tension pneumothorax is life threatening because the air in the chest not only pushes on one lung but also pushes on the heart and keeps the heart from pumping normally.

What are the symptoms?

The symptoms are:

• chest pain
• trouble breathing
• sometimes lightheadedness.

In cases of tension pneumothorax, your neck veins are enlarged. In addition, the breathing movements on the affected side of the chest may look different.

How is it diagnosed?

If your health care provider suspects pneumothorax or if you have been injured in the chest, diagnosis and treatment are usually done in a hospital.

Your health care provider will ask about your symptoms and examine you. You will have a chest x-ray. You may need an electrocardiogram (ECG). An ECG is a painless procedure for recording the electrical impulses that pass through the heart to control its activity. You may have a blood test to measure the amount of oxygen and carbon dioxide in your blood. This is called an arterial blood gas test.

How is it treated?

Treatment depends on the cause, size, and duration of the pneumothorax. A small pneumothorax may heal by itself. If you have a large pneumothorax, hospitalization and treatment may be necessary to get rid of the excess air.

If you have a pneumothorax that is causing symptoms, immediate treatment is to remove the air so the lung can reexpand to its original capacity. You will be given an anesthetic and then the air will be removed through a suction tube inserted through the wall of your chest. If the pneumothorax is small, the air may be removed simply through a needle and syringe. You will feel immediate relief, but it may take several days for the lung to totally reexpand.

Your health care provider will check your breathing by watching the up and down movements of your chest. Your heart rate and blood pressure will be checked often. You will be given oxygen if you need it.

If necessary, a chest tube will be inserted into the chest (through the ribs) to reinflate the lung and keep the area airtight while the underlying cause is treated.

If you have a tension pneumothorax, quick treatment is needed to relieve the pressure on the heart and lungs. Your health care provider may use a procedure called needle thoracentesis to reduce pain and discomfort. For this procedure, a needle is inserted into your chest to remove the air. The air immediately flows out through the needle. This helps the symptoms to improve quickly.

How long will the effects last?

Recovery from collapsed lung generally takes 1 to 2 weeks. A small pneumothorax in a healthy adult may heal in a few days without treatment. More serious cases need treatment.

How can I take care of myself?

• Follow the treatment your health care provider prescribes.
• Prop pillows behind your head and chest and take pain-relieving medicines such as acetaminophen or ibuprofen.
• Rest.
• Avoid loud talking and laughing.
• Take a cough suppressant to avoid coughing, if necessary.
• Elevate the head of your bed.
• Avoid smoking.
• Ask your health care provider if you should be doing deep breathing exercises and how you should be doing them.
• Call your health care provider if:
  • You have symptoms of collapsed lung again.
  • Your temperature rises to 101 degrees F (38.3 degrees C) or higher.
  • Chest pain or shortness of breath increases.

How can I prevent an injury-related collapsed lung from recurring?

Many cases of collapsed lung occur in car accidents. To avoid chest injuries, wear seat belts when driving or riding in a car. Secure infants and young children in car seats.