Minimal Symptoms

Patients with small spontaneous primary pneumothoraces and minimal symptoms (80% of whom will have no ongoing air leak) can be discharged with written advice and organised follow-up.

Without supplemental oxygenation, spontaneous pneumothoraces resolve at a rate of approximately 2% of the hemi-thorax volume per day [12,13].

A 1 cm pneumothorax (~15% pneumothorax) would be expected to fully resolve in approximately 10 days.

A 2 cm pneumothorax (~30-50% pneumothorax) may take 2-3 weeks to fully resolve.

Patients with spontaneous secondary pneumothoraces less than 1 cm in size and minimal symptoms do not require drainage in the emergency department but should be admitted for observation and supplemental oxygenation.

Learning bite

Never discharge a patient from the Emergency Department with a diagnosis of a secondary pneumothorax. As a minimum, supplemental oxygen and a 24 hour observation period is recommended.