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A pneumothorax occurs when air is trapped in the pleural cavity, which produces pressure on the lung. Learn more about pneumothorax in this video.

In primary spontaneous pneumothorax (PSP) requiring intervention, removal of air from the pleural space can be achieved by manual needle aspiration or by pleural drainage after insertion of a chest tube. This study aimed to evaluate the efficacy and safety of a serial-steps approach with a single system (small-calibre catheter/Heimlich valve) in a homogeneous population of patients with a first episode of PSP.

The use of small-calibre, indwelling catheters attached to a one-way valve or to a water-seal device, instead of the intravenous or thoracocentesis needle catheter, allows air evacuation to continue if the initial MA attempts fail. Such small catheters have proved successful in mixed pneumothorax (PTX) populations, most of them being iatrogenic

PSP has an incidence of 7.4-18 cases (age-adjusted incidence)/100,000 population per year in males, and 1.2-6 cases/100,000 population per year in females [4, 5]. PSP typically occurs in tall, thin subjects. Other risk factors are male gender and smoking. PSP typically occurs at rest [6]. Precipitating factors may be atmospheric pressure changes (which may account for the often observed clustering of PSP) [7] and exposure to loud music

A patient presenting with a first episode of a small (i.e., only partial, usually apical) dehiscence of the lung should not be treated, but can safely be discharged and followed on an outpatient basis.

One dreaded mistake which can be make by any seasoned pulmonologist / intensivist / radiologist is reading skinfold as a pneumothorax.