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Tag: Pneumothorax

The Needle Vs. The Knife for Spontaneous Pneumothorax: A Closer Look at the EXPRED Study

Background:  The optimal management of primary, spontaneous pneumothorax (sPTX) remains an area of active debate. The British Thoracic Society recommends the least invasive approach possible. In contrast, the American College of Chest Physicians favors first-line chest tube drainage for any …

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Thoracic and Respiratory

Don’t Believe the Headline: Ultrasound vs CXR in Traumatic Pneumothorax Diagnosis

Background:           The use of ultrasound is well established for trauma patients in the emergency department, with almost every patient receiving a FAST (Focused Assessment with Sonography in Trauma) examination as part of the “ABC’s” of trauma. Though the initial …

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Trauma

Shifting the Paradigm: Can We Manage Mechanically Ventilated Patients with Occult Traumatic Pneumothorax Conservatively?

Background: Clinically significant pneumothoraces in patients on mechanical ventilation can be dangerous as positive pressure ventilation can cause an increase in intrapleural pressure and trigger tension physiology. Occult pneumothoraces are those not suspected clinically or not evident on plain radiographs …

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Thoracic and RespiratoryTrauma

The RAMPP Trial: Randomised Ambulatory Management of Primary Pneumothorax

Background: Primary spontaneous pneumothorax, by definition, occurs without trauma or any underlying lung pathology. Often patients are otherwise young and healthy. However, management continues to be debated and may lead to unnecessary hospitalization. Previous studies regarding ambulatory management included randomized …

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Thoracic and Respiratory

Pigtail Catheter vs Large Bore Chest Tube for Pneumothorax

Background: Pneumothorax management is a common clinical condition in the emergency department (ED) occurring in patients of varying ages and caused by multiple etiologies, including spontaneous, traumatic, and iatrogenic pneumothorax. Regardless of the cause, a thoracostomy is often required for …

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Thoracic and Respiratory

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