Don't Just Do Something, Stand There (Watching Spontaneous Pneumothoraces)

Conservative management of spontaneous pneumothorax was safe and effective.

Dogma, and the American College of Chest Physicians, calls for treating large spontaneous pneumothoraces with tube thoracostomy and subsequent hospitalization, even in young healthy patients without signs of physiologic derangement (NEJM JW Emerg Med May 2001 and Chest 2001; 119:590). British Thoracic Society recommendations allow a trial of needle aspiration prior to tube thoracostomy (Thorax 2010; 65:Suppl 2). Although we know the risks associated with both procedures, the risks of not treating pneumothoraces remain poorly defined.

To better calculate the risk-benefit ratios of various treatment options for spontaneous pneumothorax, researchers randomized 316 patients in 39 Australian and New Zealand hospitals to drainage or observation. P…

Reviewing Author

Jason T. McMullan, MD, MS, FAEMS

Disclosures

Consultant/Advisory BoardEMCREG International

Grant/Research SupportNIH; Department of Defense

Editorial BoardsJournal of Emergency Medical Services

Leadership Positions in Professional SocietiesNational Association of EMS Physicians (Chair, Research Committee)