skip to main content

Neonatal Pneumothorax — RACP Paediatrics MCQ

Instant feedback + full explanation. One question, done properly.

HardNeonatologyNeonatal PneumothoraxRACP Paediatrics

A preterm infant at 25 weeks develops a left pneumothorax while on mechanical ventilation. CXR confirms a large pneumothorax with mediastinal shift. What is the immediate management?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: A — Needle decompression (2nd intercostal space, midclavicular line) followed by chest drain insertion

Tension pneumothorax in a ventilated neonate requires immediate needle decompression (23G butterfly or angiocatheter, 2nd ICS MCL) followed by formal chest drain insertion (4th ICS anterior axillary line). Transillumination with a cold light source can be used for rapid bedside diagnosis in preterm infants.

Reference: RCH Melbourne – 2024 – Clinical Practice Guidelines: Pneumothorax in Neonates