Diagnosis and treatment of traumatic pneumothorax

Chest trauma with a resulting traumatic pneumothorax is a common occurrence.

This evidence review explores the current evidence and best practice for the diagnosis and treatment of the traumatic pneumothorax. It sets out to address the areas and questions in the following:

• Diagnosis of traumatic pneumothorax - reviews the use of ultrasound and radiology in diagnosis
• Initial management regarding oxygen therapy needle decompression
• Which patients require intervention for occult and stable pneumothorax?
• Selection of catheter size for tube thoracostomy
• Finger versus tube thoracostomy
• Use of antibiotics

Download the evidence review (PDF 833.4 KB)

Key points from the review:

• There is insufficient evidence that a high concentration of oxygen improves the resolution of traumatic pneumothoraces.
• Ultrasound has a better diagnostic performance than chest radiography and is comparable with thoracic CT for diagnosis.
• Occult or asymptomatic small traumatic pneumothoraces can be safely managed with close observation alone.