这种气胸类型可发展为张力性气胸。“气胸的定义是在顶叶和肺胸膜腔之间存在空气。张力性气胸是胸膜腔在压力作用下积聚的空气。当受伤的组织形成一个单向阀，使空气进入胸膜腔，阻止空气自然逸出时，就会发生这种情况。这种情况会迅速发展为呼吸功能不全、心血管衰竭，如果得不到确认和治疗，最终会导致死亡。良好的患者预后需要紧急诊断和立即处理”(Sharma & Jindal, 2008, p.34)。以Leigh Mark为例，他现在的气胸可以从创伤性气胸发展为张力性气胸。创伤性气胸可由穿透性或非穿透性胸部创伤引起(Tsotsolis, et al, 2015)。在利马克的情况下，没有穿透本身。因此，空气不会直接进入胸壁，但在那里，由事故引起的患者胸部突然压缩可能导致肺泡破裂，导致空气进入脏胸膜空间(Sharma， &Jindal, 2008)。当空气进入胸腔时，这种破裂导致气胸。
现在，利的女儿无法理解为什么这种情况会发展成张力性气胸。这是因为一旦脏胸膜破裂那么胸腔内的不可吸收空气就会增加。随着这种不可吸收空气体积的增大，该区域的压力增大，由于压力增大而导致缺氧。随着压力的进一步增加，纵隔向反侧端移位。最后，这将导致心血管衰竭，因为恶化的缺氧。压力性气胸通常是患者缺氧和诱发的机械作用的结合(Daley, 2015)。纵隔偏曲导致机械压迫腔静脉，并随着患者缺氧而加重。最终的结果将是心脏骤停和死亡。因此，在病例研究中，有必要在病人发展为张力性气胸之前阻止病情的发展。这可以通过插入UWSD来实现。这里不应该有任何延迟，因为病人已经进入昏昏欲睡的状态，表明意识水平下降。意识水平下降通常是气胸的晚期表现(Parkin, 2002)。
This pneumothorax type can develop into a tension pneumothorax. “A pneumothorax is defined as the presence of air between parietal and visceral pleural cavity. Tension pneumothorax is the accumulation of air under pressure in the pleural space. This condition develops when injured tissue forms a 1-way valve, allowing air to enter the pleural space and preventing the air from escaping naturally. This condition rapidly progresses to respiratory insufficiency, cardiovascular collapse, and ultimately death if, unrecognized and untreated. Favourable patient outcomes require urgent diagnosis and immediate management” (Sharma & Jindal, 2008, p.34). In the case of Leigh Mark, the pneumothorax that he has now can develop from a traumatic pneumothorax to a tension pneumothorax. The traumatic pneumothorax can be caused because of penetration or non-penetrating chest trauma (Tsotsolis, et al, 2015). In the case of Leigh Mark, there is no penetration as such. So the air does not enter directly through the chest wall but there the sudden chest compressions in the patient caused by the accident might have led to the alveolar rupture resulting in air entering the visceral pleural space (Sharma, &Jindal, 2008). This ruptures leading to the pneumothorax condition when the air now enters the pleural space.
Now Leigh’s daughter is not able to understand why this condition could develop into a tension pneumothorax. This happens because once the disruption of the visceral pleura happens then the non-absorbable air in the intrapleural space will increase. With the increase in volume of this non absorbable air, there is an increased pressure in the region, hypoxia results because of the increasing pressure. With further increase in pressure, a shift is observed in the mediastinum towards the contra lateral end. And finally this will result in cardiovascular collapse because of the worsened hypoxia. The pressure pneumothorax is usually a combination of hypoxia and induced mechanical effects in the patient (Daley, 2015). The mediastinum deviation results in the mechanical compression of the vena cava’s and the exacerbated with the action of hypoxia in the patient. The end result would be cardiac arrest and death. So in the case of the patient in the case study, it is necessary to arrest development of the situation before it progresses to a tension pneumothorax. This can be done by means of the UWSD insertion. There should be no delay here, as the patient was already brought in a drowsy state indicating decreased level of consciousness. Decreased level of consciousness is usually the late findings stage in the case of pneumothorax (Parkin, 2002)