Outpatient management of primary spontaneous pneumothorax
Most stable patients with primary spontaneous pneumothorax are suitable for conservative management – i.e. they do not require a chest drain as first line management.
The key points are as follows:
- Patient must be clinically stable and meet all inclusion and exclusion criteria
- Monitor for 4 hours in ED (EDSSU when available) and repeat CXR
- If patient remains stable with no oxygen requirement and stable pneumothorax size on repeat CXR discuss with on call Respiratory Physician regarding outpatient management
- Refer for follow up at 24 hours at either Hurstville Private Hospital Respiratory clinic (if a weekday) or in ED if weekend or public holiday
- Provide patient with discharge paperwork and patient information leaflet (print out final 2 pages of the CBR)
Below is the CBR and the accompanying patient discharge information leaflet. They can also be found on the intranet in the business rule section under Primary Spontaneous Pneumothorax.