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Traumatic pneumothorax: is a chest drain always necessary?
  1. G Johnson
  1. Accident and Emergency Department, Derriford Hospital, Plymouth.


    OBJECTIVE--To examine the management of traumatic pneumothorax in a department where some of these injuries do not receive chest drains. METHODS--A retrospective study of the management of traumatic pneumothorax was performed on a unit where historically many of these injuries have been treated conservatively. RESULTS--54 pneumothoraces in a three year period were identified. Of these, 29 injuries (54.7%) were initially managed without drainage. Two patients subsequently had chest drains inserted as a result of asymptomatic radiological enlargement of the pneumothorax while inpatients. No patients deteriorated clinically during conservative treatment. CONCLUSIONS--Chest drain insertion for small or moderate sized traumatic pneumothoraces, in the absence of other significant injuries or the need for intermittent positive pressure ventilation (IPPV), may be unnecessary.

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