A 21-year-old tall, slim man presents with sudden onset pleuritic chest pain and shortness of breath. He is haemodynamically stable. Chest X-ray shows...

Question

A 21-year-old tall, slim man presents with sudden onset pleuritic chest pain and shortness of breath. He is haemodynamically stable. Chest X-ray shows a 3 cm rim of air between the right lung margin and chest wall but no mediastinal shift. He has no underlying lung disease. What is the most appropriate initial management?

Accepted Answer

High-flow oxygen and review with consideration of needle aspiration

Answer

Immediate needle decompression in the second intercostal space

Answer

Urgent chest drain insertion with underwater seal

Answer

Discharge without follow-up

Answer

Elective thoracotomy

uk-plab-1 MCQ (SBA): Primary spontaneous pneumothorax