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Traditional management of primary spontaneous pneumothorax includes tube thoracostomy and hospital admission. In a retrospective chart review, these authors evaluated a protocol for outpatient treatment of this disorder with a small-bore catheter and Heimlich valve in selected patients.
The authors identified 62 episodes of primary spontaneous pneumothorax in 50 patients who presented to the emergency department of a community hospital in Ontario, Canada, during 2000 to 2005. According to the protocol, patients with symptomatic pneumothoraces or pneumothoraces larger than 3 cm were managed in the ED by insertion of a pleural catheter (size 8 Fr) attached to a Heimlich valve and were reevaluated by chest x-ray in 1 hour. If the lung reexpande…