Pitfalls

There are a number of pitfalls that can occur during treatment of pneumothoraces:

• Failure to identify a pneumothorax as secondary and thus following the wrong BTS management algorithm
• Discharging a patient with a secondary pneumothorax from the ED
• Belief that ‘the absence of a hiss’ on attempted needle decompression excludes a tension pneumothorax
• Use of excessive force when inserting track dilators and chest drains
• Insertion of chest drains outside of the ‘safe triangle‘
• Failure to give patients advice on smoking cessation
• Failure to advise patients against flying and diving
• Failure to organise review of discharged patients