|Title:||Pneumothorax; Collapse in compliance? An audit of the management of pneumothorax in an Irish tertiary teaching centre.|
|Author(s):||E McNally, L Gleeson|
|Institution:||St James's Hospital, Dublin|
|Poster:||Click to view poster|
|Category:||General Respiratory and Sleep|
|Abstract:||Pneumothorax(PTX) commonly presents to hospital however approach to management varies. We compared our management of PTX with most recent guidelines by The British Thoracic Society(BTS).|
We conducted a retrospective review of admitted patients with PTX recorded as the primary diagnosis, excluding those electively admitted or transferred for advanced management of a persistent PTX under cardiothoracic surgery(CTS). We included 28 patients(n=28). 12(43%) primary spontaneous PTX, 16(57%) secondary spontaneous PTX. 4(14%) were admitted under CTS, 1(3%) oncology, 15(54%) pulmonology and 8(29%) general medicine.
The size measured at hilum ranged from 0.7cm– 11cm. 8(29%) cases were classified as ‘small’ ie <2cm. 3 proceeded immediately to placement of an intercostal drain. 1 required pleural aspiration followed by drainage. 4 underwent observation with 2 ultimately requiring drain placement for extension of PTX and 2 requiring no further intervention. Average length of stay among this subgroup was 2.5 days.
There was inconsistency across documentation. In 13(46%) cases, suction was applied however the timing was ambiguous in 4(14%). In 8(29%) instances, the type and size of drain was unclear. There was no documentation of safety advice for 10(36%). Overall, we showed compliance with guidelines but highlighted scope to manage a select group with PTX <2cm as outpatients