Traumatic pneumothorax is generally the result of a penetrating trauma to the chest resulting in perforation of the chest wall and the parietal and possibly visceral pleura. A blunt trauma may result in rib fracture with the broken rib then penetrating the visceral pleura. A blunt injury so severe as to open the chest wall or an excessive differential pressure between ambient and the respiratory tree may also be responsible for a pneumothorax (i.e. pulmonary barotrauma). The latter can occur while diving, at the time of ascending without exhaling fast enough (asthma may be a cause for this), or during sudden decompression at high altitude or in the decompression chamber. Surgery is another possible cause.
Flying duty can normally be resumed 6 weeks after resolution of the traumatic pneumothorax, provided full recovery from the trauma and the pneumothorax have occurred. However the ME should be confident that there is no underlying pathology that may have precipitated the event, i.e. asthma in a diver, bullous emphysema in an older pilot etc.
A chest X-ray confirming resolution of the intrapleural air and a spirometry is the minimum requirement. A respiratory physician opinion may at time be necessary. When in doubt the ME should seek advice from CAA.
A Class 1, 2 or 3 applicant may be considered as having a condition that is not of aeromedical significance if:
