Diagnosis and Management of Spontaneous Pneumothorax in the Emergency Department: A Review of the Most Current Clinical Evidence for Diagnosis and Treatment.
Spontaneous non-traumatic pneumothorax is a relatively common clinical presentation in the Emergency Department. The diagnosis of spontaneous non-traumatic pneumothorax has evolved from basic chest radiography to the reference standard of CT imaging.
Point-of-care ultrasound is another highly sensitive diagnostic modality that has gained increasing acceptance. Finally, the treatment of this type of pneumothorax has also been rapidly changing.
We give an overview of the current literature regarding the definition and classification for
pneumothorax. We discuss the current methods of diagnosis and management of spontaneous non-traumatic pneumothorax, which now include the promising treatment alternative of smaller pigtail thoracostomy catheters.
We also discuss how a rapidly placed smaller pigtail catheter may be a viable single management option for a spontaneous tension pneumothorax. The management of spontaneous non-traumatic pneumothorax has been rapidly advancing.
Viable treatment options now include observation alone, needle aspiration and placement of a small pigtail thoracostomy catheter, in addition to the use of a traditional thoracostomy tube. Although the traditional treatment for a spontaneous non-traumatic pneumothorax was placement of a larger thoracostomy tube, this may no longer be the optimal management approach in these patients.
The use of smaller pigtail thoracostomy catheters provides a viable treatment alternative to these larger catheters, and may also be used effectively as the only treatment step in a spontaneous tension pneumothorax.
Pulm Res Respir Med Open J. 2016; 3(2): 23-29. doi: 10.17140/PRRMOJ-3-127
