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.

A complication of a collapsed lung from a penetrating injury is a tension pneumothorax. This is a life-threatening emergency because the chest keeps filling with air and the air has no way to escape. The hole created by the knife or bullet can act as a one-way valve, letting air into the chest, but not letting any air escape. With each breath more air collects in the chest. The air can completely collapse the lung and then put pressure on the heart. Then the heart cannot pump normally.

What are the symptoms?

The symptoms are:

• chest pain
• trouble breathing, feeling very short of breath
• sometimes lightheadedness.

If you have a tension pneumothorax, it is hard to breathe.

How is it diagnosed?

If your healthcare provider thinks you have a collapsed lung or if your chest has been injured, diagnosis and treatment are usually done in a hospital.

Your healthcare provider will ask about your symptoms and examine you. You will have a chest X-ray. 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, or ABG.

How is it treated?

Treatment depends on the cause, size, and duration of the pneumothorax. A small pneumothorax causing mild or no symptoms may heal by itself. The extra air in the chest will be absorbed through the surrounding tissues over the next few days.

If you have a pneumothorax that is causing more than mild symptoms, you need treatment right away to remove the air from the chest so the lung can fill with air again.

• If the pneumothorax is small, the air may be removed with just a needle and syringe. You will feel immediate relief, but it may take several days for your lung to reexpand completely.
• If you have a larger pneumothorax, you will be given an anesthetic and then the air will be removed through a suction tube inserted between the ribs and through the wall of your chest. This allows the lung to reinflate. The chest tube has a seal that keeps the area airtight. The extra air gets sucked out of the chest, but no air can go back into the chest through the chest tube.
• If you have a tension pneumothorax, quick treatment is needed to relieve the pressure on the heart and lungs. Your healthcare provider may first use a needle and syringe to quickly remove air and reduce pain and discomfort. The lung will be able to reinflate. After this emergency treatment, a chest tube is usually placed to make sure the lung stays inflated and that the lung doesn’t collapse again.

While you are being observed in the emergency room, your healthcare provider will keep checking your breathing, heart rate, and blood pressure. You will be given oxygen if you need it.

If you had a small pneumothorax with mild or no symptoms and requiring no treatment, usually you will be allowed to go home the same day. You will be asked to return one or more times for chest X-rays to make sure the pneumothorax is getting smaller and the air is being absorbed.

You may need to stay at the hospital for at least a day or two if air was removed from your chest with a needle and syringe or with a chest tube. You will need to be observed to make sure your lung is reexpanding and is no longer at risk of collapsing again. Depending on your injuries and any other medical conditions you have, you may need to stay at the hospital longer.

How long will the effects last?

A small pneumothorax in a healthy adult may heal in a few days without treatment. Otherwise, recovery from a collapsed lung generally takes 1 or 2 weeks. You may have regular visits with your healthcare provider during this time.

How can I take care of myself?

• Follow the treatment your healthcare provider prescribes.
• If helpful for breathing and relieving chest pain, prop pillows behind your head and chest and take pain-relieving medicines such as acetaminophen or ibuprofen. Nonsteroidal anti-inflammatory medicines (NSAIDs), such as ibuprofen, may cause stomach bleeding and other problems. These risks increase with age. Read the label and take as directed. Unless recommended by your healthcare provider, do not take for more than 10 days for any reason.
• Rest.
• Avoid talking loudly and laughing.
• Take a cough suppressant to avoid coughing, if your healthcare provider recommends it.
• Avoid smoking.
• Ask your provider if you should be doing breathing exercises and if so, how you should be doing them.
• Call your healthcare provider if:
  • You have symptoms of collapsed lung again.
  • You have a fever higher than 101.5°F (38.6°C).
  • You have chest pain or shortness of breath that gets worse.

How can I prevent an injury-related collapsed lung?

Many cases of collapsed lung occur in car accidents. To help avoid chest injuries, wear seat belts and use airbags. Secure infants and young children in car seats according to their age, size, and car seat manufacturer’s directions.