A hemothorax is a collection of blood within the pleural cavity. This condition is caused by penetrating chest wall wounds, rupture of bronchi and lung vessels, or visceral pleura damage. It is a life-threatening situation. The bleeding can only be stopped through a thoracotomy.
The symptoms of hemothorax are pallor of the skin and shortness of breath. In some cases, the victim experiences cyanosis of the face or neck, which is a sign of traumatic asphyxia. If a massive hemothorax occurs, the patient will experience rapid growth of the hemothorax, which can cause catastrophic disorders of circulation.
A severe pneumothorax can lead to deformation of the superior vena cava and compression of the opposite lung. In addition, the patient may experience hypotension or circulatory collapse. Symptoms of a large hemothorax can include a frequent small pulse, tachycardia, and cyanosis of the face. However, these are not always signs of a serious problem.
Other symptoms of a hemothorax include attenuated breathing on one side of the lesion, a pale-cyanotic face, and rapid superficial breathing. Some patients also have a weak pulse or cold sweat. Another sign of a hemothorax is a loud tympanic sound over one lung. During a thoracotomy, the blood in the pleural space should not coagulate for at least 25 to 30 minutes.
A hemothorax can also be the result of a damaged intercostal artery or aorta. These areas are prone to injury and bleeding. They are the most common sources of pleural cavity bleeding. When a thoracotomy is performed, a syringe is used to puncture the pleural cavity. An X-ray is taken to monitor the puncture site. After the site is monitored, blood is drawn into a syringe and the exudate enters the syringe.
When a pneumothorax occurs, the air is pulled into the pleural cavity through a wound on the chest wall. There are two main types of a pneumothorax: a strained or a valve. Depending on the amount of air in the pleural cavity, a strained or a valve can be easy to squeeze by half the volume or difficult to squeeze. Symptoms of a strained or a valve can vary, but typically include a cyanotic face and pain in the chest.
Hemothorax is most often the result of a traumatic injury. These injuries are the leading causes of disability and death worldwide. The condition can be complicated by a closed chest injury with internal organ damage. During a thoracotomy, bleeding is ceased, a wound channel is created to allow air into the pleural cavity, and a drainage is provided to remove excess gas.
A thoracotomy is generally performed when the victim has a hemothorax that is more than three-quarters of an inch in diameter. A late thoracotomy is also performed, when a hemothorax is folded. Late thoracotomy is necessary when large foreign bodies are found in the lungs.
In the early stages of a massive hemothorax, the patient has difficulty in regaining venous blood to the heart. At the prehospital stage, the urgency to reinfuse the patient with blood is critical.
