Pneumothorax Management Pathway — free guideline decision tool
This tool gives management decisions for tension, primary spontaneous, and secondary spontaneous pneumothorax per BTS 2023.
Open guideline tool →Guideline-based
Implements the decision logic from published clinical guidelines.
Runs in your browser
No installation. Enter the patient's values and get a guideline recommendation instantly.
Data stays local
Nothing is uploaded. Results are for licensed clinicians only.
Worked calculation
The values below come from this tool's own example placeholders and are computed server-side with the formula shown on this page, so the arithmetic can be checked quickly. It demonstrates how to substitute values only — it is not clinical advice and not a real case.
| Type | Tension pneumothorax (hemodynamic compromise/rapid deterioration) |
|---|---|
| Symptoms/size | Minimal symptoms/small |
→PneumothoraxTension pneumothorax — immediate decompression
- Immediate management：Do not wait for imaging! Immediate needle decompression: 14G cannula at the 2nd intercostal space midclavicular line or 4th/5th intercostal space anterior/mid-axillary line; then place a chest drain
- Support：High-concentration oxygen, monitoring; minimize airway pressure in mechanically ventilated patients
- Basis：BTS 2023 / trauma airway-circulation resuscitation
| Type | Secondary spontaneous pneumothorax (SSP, underlying lung disease) |
|---|---|
| Symptoms/size | Symptomatic/dyspnea or larger |
→PneumothoraxSecondary spontaneous pneumothorax (SSP)
- Management (by hilar size)：< 1 cm: admit, conservative + oxygen observation; 1–2 cm: 14–16G needle aspiration + admit, observe; unstable/dyspnea/> 2 cm or > 1 cm after aspiration: < 14F chest drain
- Key points：SSP has poor pulmonary reserve, often needing drainage and admission; treat the underlying lung disease; minimize airway pressure in mechanically ventilated patients
- Recurrence prevention：Persistent air leak/good baseline: assess for surgery (VATS) + pleurodesis; smoking cessation
Common questions
What is Pneumothorax Management Pathway?
This tool gives management decisions for tension, primary spontaneous, and secondary spontaneous pneumothorax per BTS 2023.
How is Pneumothorax Management Pathway calculated? What is the core formula?
Tension → immediate needle decompression then chest drain. PSP minimally symptomatic → conservative; symptomatic → aspiration/Heimlich/drain. SSP → < 1 cm conservative, 1–2 cm aspiration, unstable/> 2 cm drain.
When is Pneumothorax Management Pathway used?
Use to act immediately on tension pneumothorax and to choose conservative care, aspiration, or drainage for spontaneous pneumothorax by symptoms and size.
What are the key clinical points for Pneumothorax Management Pathway?
Tension pneumothorax is a clinical diagnosis treated before imaging, whereas stable spontaneous pneumothorax is managed by symptoms rather than size alone. (original synthesis · not guideline verbatim) SSP has poor pulmonary reserve and usually requires drainage and admission. Recurrence or persistent air leak prompts VATS with pleurodesis and smoking cessation.
What are the limits and cautions when using Pneumothorax Management Pathway?
For licensed clinicians and clinical researchers. Interpret results with history, investigations and local protocols; not a diagnosis or prescription, and not a substitute for multidisciplinary decision-making or local guidelines.
How is Pneumothorax Management Pathway calculated in practice? Can you show a worked example?
Inputs: Type Tension pneumothorax (hemodynamic compromise/rapid deterioration), Symptoms/size Minimal symptoms/small → Result: Pneumothorax Tension pneumothorax — immediate decompression（Immediate management: Do not wait for imaging! Immediate needle decompression: 14G cannula at the 2nd intercostal space midclavicular line or 4th/5th intercostal space anterior/mid-axillary line; then place a chest drain, Support: High-concentration oxygen, monitoring; minimize airway pressure in mechanically ventilated patients, Basis: BTS 2023 / trauma airway-circulation resuscitation） Inputs: Type Secondary spontaneous pneumothorax (SSP, underlying lung disease), Symptoms/size Symptomatic/dyspnea or larger → Result: Pneumothorax Secondary spontaneous pneumothorax (SSP)（Management (by hilar size): < 1 cm: admit, conservative + oxygen observation; 1–2 cm: 14–16G needle aspiration + admit, observe; unstable/dyspnea/> 2 cm or > 1 cm after aspiration: < 14F chest drain, Key points: SSP has poor pulmonary reserve, often needing drainage and admission; treat the underlying lung disease; minimize airway pressure in mechanically ventilated patients, Recurrence prevention: Persistent air leak/good baseline: assess for surgery (VATS) + pleurodesis; smoking cessation）
Run Pneumothorax Management Pathway now
This tool gives management decisions for tension, primary spontaneous, and secondary spontaneous pneumothorax per BTS 2023.
Open guideline tool →For licensed clinicians. Not a substitute for clinical judgement.
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