Article Text

Download PDFPDF
Primary spontaneous tension pneumothorax in a submariner at sea
  1. F J H Brims
  1. Adult Intensive Care Unit, Royal Brompton Hospital, Sydney Street, London SW3 6NP, UK;

    Statistics from

    Request Permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

    Tension pneumothorax is normally associated with trauma,1–3 and ventilated patients.2,4,5 It is a rare diagnosis that should not be missed and may be overlooked in other settings. It may not present with all the “classic” signs leading to a potential delay in treatment.1


    While serving on a nuclear submarine a 23 year old sailor presented acutely unwell after exercise. He was an extremely fit sportsman of average height and build who was a smoker with no significant medical history.

    He was dyspnoeic, and complaining of sudden left sided pleuritic chest pain. On examination he was sweaty and tachycardic with deteriorating consciousness, becoming rapidly weaker and confused. There was reduced expansion and absent breath sounds on the left side, his trachea was deviated to the right, neck veins were prominent, and apex beat was not palpable. Of note, there was no hyper-resonance on the affected side.

    He was placed on high flow oxygen and positioned to maintain …

    View Full Text