🫁 Pneumothorax Management Pathway
This tool gives management decisions for tension, primary spontaneous, and secondary spontaneous pneumothorax per BTS 2023.
Pneumothorax Management Pathway
Type
Symptoms/size
When to use
Use to act immediately on tension pneumothorax and to choose conservative care, aspiration, or drainage for spontaneous pneumothorax by symptoms and size.
How it works
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.
Key points
- 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.
References
Decision support for licensed clinicians only; not a substitute for clinical judgement, diagnosis or local protocols.