Consensus Statements
Management of Spontaneous Pneumothorax
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Table 8Primary Spontaneous Pneumothorax With Signs and Symptoms Present <24 H: Initial Management
| Certain circumstance |
Acceptable rarely |
Inappropriate |
Indeterminate option |
| 2. Admit, observe (G) |
3. 6. Aspiration of any type (G)
7. Chest tube (any size), admit (G) |
8. Thoracoscopy (VG) |
|
| 5. Aspirate, Heimlich, discharge (G) |
3. Aspirate, remove catheter, observe, discharge (G)
4. Aspirate, remove catheter, admit (G) |
1. Observe, discharge (VG)
2. Admit, observe (VG)
8. Thoracoscopy (G) |
|
| 6. Aspirate, Heimlich, watch overnight (G) |
4. Aspirate, remove catheter, admit (G)
5. Aspirate, Heimlich, discharge (G) |
1. Observe, discharge (P)
2. Admit, observe (P)
3. Aspirate, remove catheter, observe, discharge (VG)
8. Thoracoscopy (VG) |
|
| Pneumothorax size |
Patient stability |
Preferred management |
Acceptable management |
| Small |
Stable |
1. Observe, discharge* (G) |
|
| Large |
Stable |
|
6. Aspirate, Heimlich, watch overnight (SC)
7. Chest tube (any size), admit (SC) |
| Large |
Unstable |
7. Chest tube (any size), admit (VG) |
|
*Numbers refer to the management options found in Table 7 containing a complete description of the option.
Levels of consensus (Table 4) appear in parenthesis after option: P = perfect, VG = very good, G = good, SC = some consensus, NC = no consensus. |
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