Pneumothorax – Medical ones

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


  • 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



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