Wednesday, June 22, 2011

Tracheal shift can help with you quickly diagnose lung disorders

So you're wondering what might be the cause a a patient's respiratory distress. One assessment skill that might help you lean one way or another may be as simple as checking the position of the trachea, or at least looking at the x-ray.

The following are tracheal positions and diseases conditions they may indicate:

A. Tracheal shift toward the problem: due to a vacuum effect created on that side of the lung.
  1. Spontaneous Pneumothorax (Collapsed lung, such as one caused by a bleb)
  2. Pneumonectomy (lung removed)
B. No movement of trachea:
  1. Pulmonary consolidation (pneumonia, pulmonary edema)
  2. Mesothelioma
C. Tracheal shift away from the problem: Pressure produced by disease process pushes trachea away.
  1. Pleural effusion: fluid buildup in the pleural cavity surrounding one area of the lung
  2. Hemothorax: buildup of blood in one area of the lung
  3. Tension Pneumothorax:  Accumulation of air in the pleural sac.  Air can get into the pleural sac but not out.  The increased pressure may push trachea away from the problem.



Anonymous said...

In pneumothorax, Trachea shifts away from affected side.
The air in the LEFT pleural space would push the trachea towards RIGHT.

If i am wrong, please explain it.

Rick Frea said...

I was actually referring to a bleb type pneumothorax. If part of the lung collapses and air escapes into the thoracic cavity, the trachea "may" shift in that direction. In the case of a tension pneumothorax, where air gets into the pleural space but can't get out, the trachea "may" shift away from the affected side. Thanks for the question. I've added tension pneumothorax to the above post.

Rick Frea said...

Hopefully this will clarify things a bit for you.