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Consensus Statements

Management of Spontaneous Pneumothorax
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Initial Management: Clinically Stable Patient with a Small PSP

Management Options (listed in order of preference)
  1. Observe and discharge

The patient should be observed in the emergency department for 3 to 6 h and discharged home if a repeat chest radiograph excludes progression of the pneumothorax (good consensus).

Follow-up: Patients should be provided with careful instructions for follow-up within 12 h to 2 days depending on circumstances. A chest radiograph should be obtained at the follow-up appointment to document resolution of the pneumothorax.

  1. Admit and observe

Patients may be admitted for observation if they live distant from emergency services or follow-up is considered unreliable (good consensus).

Note: Simple aspiration of the pneumothorax or insertion of a chest tube is not appropriate for most patients (good consensus) unless the pneumothorax enlarges.

Primary Data

Table 8—PSP With Signs and Symptoms Present <24 H: Initial Management
Table 10—Management Recommendations for Patients with PSP Selected for Observation

 

Other Information

Did your patient's pneumothorax progress during observation and develop a large pneumothorax? If so, click on:

Clinically Stable Patient with a Large PSP
Clinically Unstable Patient with a Large PSP

Would you like information regarding when to provide recurrence prevention and what type of recurrence prevention to provide? If so, click on

Recurrence Prevention Information

Would you like information regarding the role of computed tomography in the management of primary spontaneous pneumothorax? If so, click on

Computed Tomography

 

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