Case 1

A young man presents with left sided chest pain and dyspnoea which started the previous day. He is previously well and on no regular medications. He smokes 5-10 cigarettes per day.

His observations at initial assessment are:

• Pulse 98 reg
• BP 126/68
• RR 20bpm
• SaO₂ 95% on room air
• Temp 36.4^o

^?On examination he is tachypnoeic and appears to have some discomfort. He appears alert and well perfused. His trachea is midline and he has decreased expansion and breath sounds on the left side. His ECG, carried out on arrival, shows normal sinus rhythm. You send him for a chest x-ray (click on the x-ray to enlarge). What does the image show?

You successfully aspirate 1.5L air from the patient’s left chest and he reports some easing of his dyspnoea. You perform a second chest x-ray.

Click on the x-ray to enlarge.

Select the statements which are true.