Diving and flying with pneumothorax

[sliceofbread136]

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Hoping anyone can correct anything inaccurate in this thought experiment:

flying: atmospheric pressure is down, so via Boyle’s law this is bad and volume goes up. You get a tension pneumothorax. I feel like this one is simpler.

diving: this one I feel is trickier. Via Boyle’s law this should shrink the pneumo... however then when you consider you are making your intrapleural pressure positive you no longer have a trans pulmonary pressure opposing surface tension and elastic recoil making a similar situation to a forced expiration. Sooo I think this case produces atelectasis in the area of the pneumo? But I am not entirely sure

 

[Just Call Me Doc]

Depends on a few things: how is the patient breathing? Also, where is the opening for the tension pneumo (internal or external)?

 

[deleted480308]

What is the urgency for them to do either?

 

[Just Call Me Doc]

What is the urgency for them to do either?

Well, flying is a consideration for air CASEVAC (e.g. gunshot wounds to the chest during combat). Generally try to keep helicopters flying low when carrying a pneumo patient. No idea for for any urgency for diving.

 

[mehc012]

What is the urgency for them to do either?

They have an upcoming due date for a homework assignment 😛

 

[sliceofbread136]

What is the urgency for them to do either?

just a thought experiment. I dunno let’s say they are a secret agent of something.

 

[sliceofbread136]

Depends on a few things: how is the patient breathing? Also, where is the opening for the tension pneumo (internal or external)?

I didn’t consider either of these things...mind explaining how these would change things??

 

[sliceofbread136]

They have an upcoming due date for a homework assignment 😛

im on an elective and am now “remote learning” from home which has resulted in too much time to ponder physiology questions.

sometimes it’s easier to just ask smarter people on sdn

 

[Just Call Me Doc]

I didn’t consider either of these things...mind explaining how these would change things??

If the patient is breathing underwater, they're breathing pressurized air which counters the extrathoracic pressures (which is why scuba divers can breath underwater). If they're holding their breath then air in all chambers will decrease in size. If the tension pneumo is internal, then pressurized air may make the pnuemo worse (positive pressure). If it's external, then it depends if water can leak in or not. There are various scenarios depending on the details of the injury and situation.