What to Do for a Collapsed Lung

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This survival-medicine website provides general information, not individual advice. Most scenarios assume the victim cannot get expert medical help. Please see the disclaimer.

What to Do for a Collapsed Lung

In this X-ray, both lungs are collapsed. The arrows point to the outside linings of the lungs. The black areas are air.

by James Hubbard, MD, MPH

I remember one patient in particular, a nurse. I was less than a year out of training. She was working on the floor when I was in the emergency room. She came up to me and said, “I think I have a collapsed lung.” She was holding the side of her chest and obviously in pain but didn’t appear short of breath.

This was a first for me—someone just coming up and self diagnosing such a thing. I asked her how she knew. She said she’d had a couple before. Ohhh. I’d read about this. If someone’s had one spontaneous collapsed lung they’re at increased risk to have another—especially among smokers, and I knew she was one of those. Their small airway walls thin out, and sometimes one can spring a leak of air into the space between the lungs and the chest wall. Voilà—collapsed lung.

Anyway, when I listened to her chest with a stethoscope, she had decreased breath sounds on the side of the chest with the pain. Her oxygen level was good, but a chest X-ray showed a small pneumothorax (partially collapsed lung). She took some anti-inflammatories and stayed off work a few days; the leak sealed over, and soon the chest X-ray (and she) was back to normal.

What Causes a Collapsed Lung

Books adA pneumothorax means air (pneumo) in the chest (thorax). This happens when air leaks into the space between your lungs and your inner chest wall.

Normally this area is what we call a “potential space” because the lungs touch the chest wall. (There’s really no space, but there could be.) When you expand your chest, your lungs keep touching the chest wall and expand also. That brings in the air we all need to breathe. If something like air or fluid gets into that potential space, it takes the place of where the lung should be. All the lung can do is reduce in size or collapse.

Reasons for a collapsed lung:

  1. A puncture from a broken rib. That’s the kind I was familiar with before the nurse.
  2. A puncture wound through the chest wall. If a knife or stick or the like punctures the chest wall, air comes pouring in from the outside.
  3. A weak spot in the lung that starts leaking. Emphysema or other smoking damage to the lungs can do this, as can asthma, pneumonia, or lung cancer. Some people are born with a little bleb, or weak spot.

These are the ones you’re going to see in the field. In a hospital setting a lung can be damaged by surgery or a procedure like a bronchoscopy (looking down into the lungs with a long, lighted tube). The added lung air-pressure of being on a ventilator can do it too.

Signs and Symptoms

Symptoms: Usually you’ll have sudden pain on the affected side of the chest, and shortness of breath.

Signs: With a stethoscope or an ear to the back of the chest, you may hear that the breath sounds are notably decreased or absent on the side of the pneumothorax.

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The definitive treatment for a large pneumothorax (collapsed lung) is a chest tube hooked up to a device that provides constant suction so the hole has time to heal. This man has a chest tube in his right lung. It’s the tube coming from under the bandage. (Most of the other tubes are monitor wires.)


If there’s a puncture wound through the chest wall, you’ll need to seal it with something like petroleum jelly and a bandage.

Until you can get to a medical facility you’re just going to have to decrease your activities (thereby decreasing your need for extra oxygen) and take whatever you have for pain. Many leaks heal on their own.

If there is severe shortness of breath and you’re not going to be able to get expert help, as a last resort, you can stick a hollow 18- or 20-gauge needle (with a syringe on it) over the top of one of the ribs in the area where there are no breath sounds (in the back or side of the chest). The reason it should be just over the top is a nerve, artery, and vein run underneath each rib, and you don’t want to hit those.

The needle is going to need to be one-and-a-half inches, or longer, to get into the chest cavity. As you go in, pull back on the syringe. You’ll know you’re in the right place if you start pulling back air. Don’t go further or you could stick the lung and make it worse. Also there’s always the risk for infection. In other words, like most medical procedures, this can be dangerous. Only do it as a last resort in someone who looks like they’re not going to last long enough to get expert medical care.

But, if there’s a large pneumothorax (and that’s usually the case if there’s severe shortness of breath), the definitive treatment is inserting a chest tube hooked up to a device applying constant suction for several hours to a few days, to give the leak time to heal. Unless you have this in your medical kit (and some people do) you’re going to have to suck as much air out as you can with the needle and syringe until the person is breathing better or you can get help. Use a 10cc or even 50cc syringe if you have it so you’ll only need to stick it in once or twice. Of course some holes never heal without surgery.


One other thing. You can get something called a tension pneumonthorax. Instead of the air pressure equalizing, the leak becomes a one-way valve. It pushes air in, but the air cannot escape. This puts enough pressure on the heart and other lung that it becomes a true emergency. The blood pressure drops and the pulse increases. Often the person becomes less alert and may lose consciousness. The heart may even stop. The treatment is relieving the pressure immediately. More on that in another post.


Have any of you ever had a collapsed lung? How did it happen? What were your symptoms? How was it treated?

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X-ray courtesy Morgan Le Guen, Catherine Beigelman, Belaid Bouhemad, Yang Wenjïe, Frederic Marmion [CC-BY-2.0], via Wikimedia Commons. Collapsed-lung patient photo by Kairuuinzuro on Flickr.

  • Emmanuel

    i was diagnosed with fluid in my left lung back in 2014 which the dr said was as a result of TB. i was Inserted a chest tube which removed the fluid but after an x-ray the lung was small and couldn’t get back to its shape. since then my left side of the chest is smaller than the other. i have no breathing problems though i feel tight in the left side. Apart from the chest tube can i recover through excise or what can i do to restore the sharp of the chest? is there any danger living with the collapsed lung?

    • http://thesurvivaldoctor.com/ James Hubbard, MD, MPH

      You should ask your treating doctor about your specific case but, in general, exercise should help.

      • Emmanuel

        thank you

  • Fernando

    Just wanted to share my personal experience of my lung collapse.
    I’m a male, 51 years of age, no history is smoking, in excellent physical condition.
    This is my 2nd case of spontaneous pneumothorax on my left lung. The previous one was mid November 2009. Symptoms for the first case felt like I pulled a back muscle, just to the inside of my left shoulder blade, couldn’t catch my breath for a few minutes, which I thought I was having a heart attack. I was able to recover after a few minutes. I didn’t see a doctor till after the Thanks Giving holidays, which was 2 weeks later. I was told by my doctor to go to the ER.

    In the ER, they installed a pigtail catheter, I leaked for about 5 days, which I ended up having surgery to correct it, VATS pleurodesis, no talc was used.

    This latest case happened Monday 11/23/15. I felt it after having breakfast, I took a deep breath and I felt pain on my back just to the inside of my left shoulder blade, same spot as the previous case, but I didn’t lose my breath. This time it was the pain that limited me from taking a deeper breath. I feared the worst that it might be a lung collapse.
    About an hour later I decided to test it out my suspicions and tried to take a deeper breath, this time it was a shooting pain, more intense than the first, stopped me on my tracks, not sure if the pain or the out of breath or both that was what stopped me on my tracks. A few minutes later after I recovered, I tried it again, same exact thing.
    I mentioned to my wife that I was worried that I might have another lung collapse. My wife persuaded me to go to the ER. I refused, still in denial. I confirmed it when I went to bed, lying down flat on my back,I had difficulty breathing, just trying to turn to my left, I felt intense pain in the same area on my back. My wife persuaded me to go with her to the ER. I managed to convince her that I was too tired to wait hours in the ER, that I would catch a ride with her in the morning when she goes to work. I was able to sleep without difficulty breathing on my right side.

    They took an X-ray in the ER, it was confirmed, I was told that it was a pretty substantial collapse on my left lung. The ER surgeon installed a pigtail catheter on my upper left chest, even with local anesthesia, I thought it was more painful than the first time I had one put in 6 years ago.

    I went through another VATS pleurodesis, this time both mechanical and chemical (using doxycycline) I told my surgeon that I didn’t want talc in my body. Hoping it’s good this time around.

    • http://thesurvivaldoctor.com/ James Hubbard, MD, MPH

      Thanks for sharing, Fernando.

  • Brooke Adamy

    In Nov 2014, I suffered from my first collapsed lung. I had another one in June and another one occurred last night (8/29). I never thought much about it until I came across an article on Catamenial Pneumothorax. Each time these have occurred I have been on day 1 of my menstrual cycle and I have some issues with my woman parts. I guess my question is which dr should I discuss my concerns with. I know the cases are very rare but I’m just puzzled on how every time it has occurred I just have happened to start my cycle.Thank you for reading this.

    • http://thesurvivaldoctor.com/ James Hubbard, MD, MPH

      Brooke, I’d start with your gynecologist. The reason for a menstrual-related pneumothorax is still poorly understood but the latest thought is they are a much more common reason for a pneumo than previously thought. There are some treatments that seem to help. If you have a medical school in your area you might ask your gyn if there are any docs with a special interest in such, or check that out on your own.

  • Anita

    When a chest tube is used to relieve a pneumothorax, how does the hole left upon removal of said chest tube differ to the trauma of the pleura which caused the pneumothorax in the first place? How does this hole not cause ongoing issues?

    • http://thesurvivaldoctor.com/ James Hubbard, MD, MPH

      It’s really more of a slit through chest wall and the tube is poked through. It’s more of I-shaped than O-shaped. When the tube is taken out, the slit comes back together so it’s close to being sealed at that point. The slit is sutured and bandaged.

      • Anita

        Thanks. It’s sutured and bandaged externally. what about internally, the slit to access the pleural space? Are there any theories about how this corrects itself? I’m just trying to get my head around the idea that to treat the repercussions of damage to the pleura, we cause more damage to the pleura by penetrating it with a tube. I understand that this works clinically, but I cant’ find reliable information as to how. I would think that it’s a very common question? I imagine the edges come back together, clotting fibrin etc,? do you know of any good sources of information regarding this?

        • Anita

          or know how common it is that once the original offending trauma is sealed the drain is removed the penetration from the drain causes a reoccurance?

          • http://thesurvivaldoctor.com/ James Hubbard, MD, MPH

            First remember that the lung is like a sack enclosed in on pleural lining. The chest wall is enclosed lined with separate pleura. The tube only penetrates the pleural lining of the chest wall. I would think it heals back like any other wound. I know of no risk that the penetration of the wall causes any recurrences down the road. All sutures do is to keep the walls of a wound together so they heal back quicker and with less scarring. On the other hand, if there is a closed pneumothorax, where the actual lung lining leaks, rarely this might need to be surgically sutured shut. But even then, as far as the chest tube wound goes, it heals when the tube comes out with no recurrence of that opening.

  • Danielle Cass

    Hi, just last Tuesday my right lung collapsed…pneumothorax. I’m a female, 29 years old, ab
    out 5`6, 146 lbs. I went to the ER Wednesday morning, they did the xray, discovered it was collapsed, I got admitted, got the chest tube, had it removed and got released on Friday. So my question….this is now the following Monday. Is it normal to feel discomfort or “aches” in my abdomen? Along with every nw and again having the dizzy feeling? Prior to all this, I smoked pretty heavily for 15 yrs, however, I am done with tht, because I am not trying to relive that moment ever again. My last cigarette was last Wednesday.

    • http://thesurvivaldoctor.com/ James Hubbard, MD, MPH

      I suppose you could have some muscle aches or hurt some in the upper abdomen near the diaphragm and occasional dizziness. If it’s getting worse though, you should check with your doctor and see what he/she thinks.

  • Cattle Drive

    I am 16 and I have had three spontaneous pnuemothoracies, one on my left last year and two on my right in January. I have never smoked anything my entire life by the way. I am pursuing a medical career so I am trained in first aid and I know where and how to place a chest tube. My question is that my family and I are going on vacation and we will be on jeeping trails for multiple hours. If I have a large pneumothorax and a chest tube is needed but we are not close to medical resources, what should my parents do? Is there anything we should bring with us just incase? And if so, where could we get it? This of course being a last resort.

    • http://thesurvivaldoctor.com/ James Hubbard, MD, MPH

      Inserting a chest tube requires skill and practice to do it right. Your best bet on vacation is to never be out of cell phone range and don’t get out too far by yourself. That way you should be able to get help pretty quickly without too much exertion your part. Also be sure to get your doctor’s advice before you go.

  • Sarah

    Hi, so I just came across this website, but I was wondering if you could help me? So for the past 2 weeks or so I have had this really bad pain in my chest it felt like someone was punching me over and over again, the pain has also moved down to my ribs and the pain gets worst when I move or breathe and I don’t know what to do.

    • http://thesurvivaldoctor.com/ James Hubbard, MD, MPH

      Sophia, I can’t make an individual diagnosis or specific recommendations without an exam. It sounds like you need get checked out your doctor, PA, or NP. In general, hurting when moving hints at something going on in the actual ribs or muscles of the chest wall such as a bruise, strain, costochondritis (http://www.thesurvivaldoctor.com/2012/11/08/non-heart-chest-pain/ ) but there’s no way I could tell if that’s your problem or something else without an exam.

  • Brad C.

    Hi Dr. Hubbard; Was wondering if you might be able to help me. Years ago I had a left lung collapse and had a chest tube for several days. Ever since then I have had a leak in that lung because I know what the pain feels like but over the past few years the air has been escaping my chest cavity and getting below my diaphragm as I can hear the air make sounds as it is going through and down and (the pain will subside in my chest and immediately begin hurting in my left side) (colon area) and around my stomach area. Sometimes I can feel the air in my upper back on the other side of my heart and sometimes it makes my heart beat strangely. When I have talked to my regular GP, he will take an x-ray of the lung and of course it is not collapsed because the air is escaping down and the lung is no longer collapsing. I have also had colonoscopies done over the years but of course they don’t help to see the problem because the problem is (not inside) the colon. I know and can feel exactly what is happening but don’t know how to get a Dr. who hasn’t experienced it and isn’t feeling it to understand and maybe help me. I know that it is rare for air to escape the chest cavity but that is what’s happening! I have read online of a few cases. That’s probably why the Dr. isn’t understanding because of the rarity and he hasn’t heard of it. I’ve just suffered so long with it and would like to know who I could see or how to go about explaining it in order to to finally get help. I know that free air is causing the pain that moves around so much inside because it starts with my lung and I know the pain and the leak has never sealed. Thank you!

    • http://thesurvivaldoctor.com/ James Hubbard, MD, MPH

      A plain x-ray of the abdomen should easily show free air. And, yes, it would be very rare for what you describe. Perhaps you could see a pulmonary doctor but, at some point, you should consider you may be mistaken in what you think is happening and ask the doctors what else it could be. Again, free air in the chest or abdomen is not a very difficult thing to detect.

      • Brad C.

        Thank you for responding. I may look for a pulmonologist. What ever is going on is very strange because it moves around so much and sounds like air. When it moves down to around my colon area, I can push on my side and it will move over to around my stomach and hurt there and if I push around my stomach it will move on over to my right side around kidney area. What else could move in such a way besides free air?

      • http://thesurvivaldoctor.com/ James Hubbard, MD, MPH

        Brad, one other possibility I thought of other than leaked air is air in your esophagus causing it to spasm. Maybe there’s a stricture?. and then going down into your stomach causing spasm there. Just a thought, but in addition to your lungs, you might have that checked by your regular doctor or by a gastroenterologist.

        • Brad C.

          Thanks. I may have to find a gastroenterologis also. When the pain is in my chest and I try to eat, sometimes the food gets stuck and I can’t swallow and it stays there for a few minutes before I feel it finally squeeze on through. That also hurts.

          • Eliza Selman

            I might have to go to the doctor because 5 and a half years ago, when I was 4 U was ran over on my stomach by a four-wheeler and it may have damaged my lungs because when I run even for only 5 seconds I can’t breathe. I don’t have.Cystic Fibrosis or asthma.

          • http://thesurvivaldoctor.com/ James Hubbard, MD, MPH

            In that case, ask your doctor about referral to a gastroenterologist. I wouldn’t delay.

          • Brad C.

            Ok, Thanks!

  • Raghu

    My sister has been diagnosed with TB few months back and she was on medication. In spite of regular treatment and followup her left lung collapsed few weeks back. We consulted few doctors in the to reinflate the lung. The Drs gave 50% chance of recovery. Before the treatment we have been advised to do 3D x-ray which gave out the depth of affected lung. After the results Dr told the lung is totally collapsed and there is not chance of recovery. We then asked the Dr to remove the affected/collapsed lung so that my sister can stay well with one lung. Dr advised, since you are doing well and not been affected further, why to take the chance of removing the affected one and to cause any other problem. Now we are questioning ourselves about the situation we are in to be more clear and safe. The question is, will the infection caused in the collapsed lung will cause further problem with the other lung?. Or is it better to remove the entire lung?
    Kindly advise.
    Looking forward.
    raghu (India)

    • http://thesurvivaldoctor.com/ James Hubbard, MD, MPH

      You could always get a second opinion. I am not at all an expert on TB but what your doctor advised makes sense to me.

      • Raghu

        Thanks much for the reply.

  • Beginner

    Hi! On the picture, the person seems to have the thorax open (maybe it is not the proper way to say it), as when we take a deep breath. The right side looks more open than the left side. Is this also a clue for a collapsed lung or not?

    • http://thesurvivaldoctor.com/ James Hubbard, MD, MPH

      Sorry, but I’m not sure what you mean. If you’re referring to the picture of the man on the bad, I don’t think there’s any clue (other than the chess tube) that he has a collapsed lung

      • Beginner

        Exactly, I was referring to that picture. I think it answers my question. Thank you!