Pneumothorax

Question 1

Primary pneumothorax

Answer 1

No underlying lung disease

Question 2

Secondary pneumothorax

Answer 2

Underlying lung disease

Question 3

Primary

Asymptomatic and rim of air under 2cm on CXR

Answer 3

Consider discharge

Question 4

Primary

Symptomatic or rim of air over 2cm on CXR

Answer 4

Aspiration

2nd intercostal space mid clavicular line, 16G cannula

Repeat if unsuccessful and discharge if successful

If unsuccessful again -> chest drain

Question 5

Secondary

SOB and/or rim of air over 2cm and age over 50

Answer 5

Chest drain

Fourth intercostal space mid axilliary line

Question 6

Secondary

Rim of air 1-2cm

Answer 6

Aspiration

If fails chest drain

All admitted for at least 24hrs

Question 7

Secondary

Less than 1cm

Answer 7

Admit for 24hours with oxygen

Question 8

Relieving a tension pneumothorax

Answer 8

Large bore IV cannula through 2nd intercostal space mid clavicular line

Then formal chest drain

Question 9

Aspirating pneumothorax

Answer 9

Never aspirate over 2.5 L