Management of Tension Pneumothorax in Lung Infections

Critical Management Principles

Immediate needle decompression followed by chest tube placement is life-saving and must be performed emergently in patients with tension pneumothorax, according to the American College of Chest Physicians 1
Insert a cannula of at least 4.5 cm length into the second intercostal space in the mid-clavicular line, as recommended by the American College of Surgeons 1
Never clamp a bubbling chest drain, as this can lead to fatal tension pneumothorax, warned by the British Thoracic Society 2, 3

Patients on positive pressure ventilation who develop any pneumothorax should always receive tube thoracostomy, as stated by the American Thoracic Society 1
Tension pneumothorax is particularly suspected in mechanically ventilated patients or those on non-invasive ventilation who suddenly deteriorate, noted by the American Heart Association 4, 1
In asthma patients on mechanical ventilation, tension pneumothorax is rare but life-threatening and should be considered with sudden deterioration, cautioned by the American College of Cardiology 4