Spontaneous Pneumothorax; a Collapse in Management?

Revised guidelines for the management of spontaneous pneumothoraces were published by the British Thoracic Society in 2010, however compliance remains poor. A retrospective review was performed on patients diagnosed with a pneumothorax over a 26 month period (January 2012 to March 2014). Of the 57 patients identified, 43 (75%) were diagnosed with spontaneous pneumothorax. 12 patients (21%) had pre-existing lung disease, and 16 patients (28%) admitted to having had a previously documented pneumothorax. 19 patients (33%) were reported as smokers. The main symptoms reported were chest pain (93%) and shortness of breath (54%). Observation was appropriate in 18 cases (31%), while aspiration alone was performed in 9 (16%) with chest drains required in 25 cases (44%). Five patients (9%) were admitted directly under a medical team. Our study demonstrated good compliance with BTS guidelines. The decision to observe, aspirate, insert a chest drain or directly refer to the medical team was appropriate in the majority of cases studied.