To drain or not to drain? – that is the question (Follow the BTS algorithm).This is not for Tension!
Treatment Suggestion: Large pneumothorax consider placing a Seldinger drain instead of needle aspiration.
- Its small and no more painful
- Measure volume removed (counting 50ml syringes)
- Turn off while awaiting CXR
- Drained?
- Enough – can remove
- Not enough – can then connect to seal and open
Other Conditions to Consider
- Pregnancy – More common in pregnancy – and best treated in most minimally invasive as possible.
- Catamenial(menses related) – Under diagnosed and requires surgical intervention and hormonal manipulation (after initial therapy)
- Cystic Fibrosis – Treat as secondary but early consideration of surgical treatment advised
- AIDS – Treat as secondary but early consideration od HIV treatment and surgical intervention
Discharge/Follow-Up
- Ensure Follow up arranged either through respiratory clinic or AAU
- Discharge advice [ensure documented in notes & Advice sheet given]
- Increased Symptoms – Immediate return to ED
- Flight – None until full resolution confirmed
- Diving – None until Bilateral Pleurodectomy and Normal FU CT
PDF:pneumo
