Management of Suspected Pneumothorax - Flowchart
Management of Suspected Pneumothorax - Flowchart Management of Suspected Pneumothorax Management of Suspected Pneumothorax
Flowchart

Suspected pneumothorax (Table 64.1)
Sudden breathlessness or chest pain


Otherwise fit young adult
Following invasive procedure
Hypoxaemia or hypotension in a ventilated patient

Suspected pneumothorax (Table 64.1)
Sudden breathlessness or chest pain


Otherwise fit young adult
Following invasive procedure
Hypoxaemia or hypotension in a ventilated patient

Suspected pneumothorax (Table 64.1)
Sudden breathlessness or chest pain

Table 64.1


Otherwise fit young adult
Following invasive procedure
Hypoxaemia or hypotension in a ventilated patient


Otherwise fit young adult
Following invasive procedure
Hypoxaemia or hypotension in a ventilated patient

Decompress with large-bore needle, 2nd intercostal space in midclavicular line on side with absent/reduced breath sounds (Table 64.3)

Decompress with large-bore needle, 2nd intercostal space in midclavicular line on side with absent/reduced breath sounds (Table 64.3)

Decompress with large-bore needle, 2nd intercostal space in midclavicular line on side with absent/reduced breath sounds (Table 64.3)

Table 64.3

End

End

End

Key observations (Table 1.1)
Give high-flow oxygen

Key observations (Table 1.1)
Give high-flow oxygen

Key observations (Table 1.1)
Give high-flow oxygen

Table 1.1

Signs of tension pneumothorax? (Table 64.2)

Signs of tension pneumothorax? (Table 64.2)

Signs of tension pneumothorax? (Table 64.2)

Table 64.2

Yes

Yes

Yes

No

No

No

Obtain CXR
Tube drainage (Chapter 122)

Obtain CXR
Tube drainage (Chapter 122)

Obtain CXR
Tube drainage (Chapter 122)


Chapter 122

Obtain chest X-ray (CXR) (Box 64.1)
Maximum size of pneumothorax (lung edge to chest wall at level of hilum)?

Obtain chest X-ray (CXR) (Box 64.1)
Maximum size of pneumothorax (lung edge to chest wall at level of hilum)?

Obtain chest X-ray (CXR) (Box 64.1)
Maximum size of pneumothorax (lung edge to chest wall at level of hilum)?

Box 64.1

< 2 cm (small)

< 2 cm (small)

< 2 cm

2 cm (large)

2 cm (large)

>=2 cm

Observation

Observation

Observation

Needle aspiration (Table 64.3)

Needle aspiration (Table 64.3)

Needle aspiration (Table 64.3)

Table 64.3

No symptoms

No symptoms

No symptoms

Symptoms

Symptoms

Symptoms

Clinical review: Discharge if resolved or stable
Repeat CXR in 7-10 days.
Advice: No scuba diving. No air travel until 1 week after resolution

Clinical review: Discharge if resolved or stable
Repeat CXR in 7-10 days.
Advice: No scuba diving. No air travel until 1 week after resolution

Clinical review: Discharge if resolved or stable
Repeat CXR in 7-10 days.
Advice: No scuba diving. No air travel until 1 week after resolution



If aspiration unsuccessful, Tube drainage

If aspiration unsuccessful, Tube drainage

If aspiration unsuccessful, Tube drainage

Tube drainage (Chapter 122)

Tube drainage (Chapter 122)

Tube drainage (Chapter 122)

Chapter 122

Primary (Table 64.1)

Primary (Table 64.1)

Table 64.1 Primary

Secondary (Table 64.1)

Secondary (Table 64.1)

Table 64.1 Secondary