Pneumothorax and its initial management

Most cases of pneumothorax are spontaneous and have no particular reason for their occurrence. They arise from small blebs which may be multiple and can be the cause of recurrent pneomothoraces. Patients typically present with mild shortness of breath, pleuritic chest pain and cough.

Initial management for those that are not tension pneumos is to aspirate a liter or as much is comfortably extractable done (whichever is LESS). Re X-ray and see the benefit. If there is significant benefit, one may remain without a chest tube and redo an X-ray the next day. The patient does not need to be in the hospital for this. if there is little or no improvement after this, it indicates a persistent leak and a chest tube should be inserted.

Tension Pneumos are a completely different story