Discrepancies in the detection and management of spontaneous pneumothorax: eight years after publication of guidelines

Abstract

The British Thoracic Society (BTS) guidelines for the detection and management of spontaneous pneumothorax have been published for over eight years. The condition continues to be managed by surgical and medical staff, especially in DGH settings. This study evaluates any recognition and initial management discrepancies in a uncomplicated pneumothorax case and documents any deviancies from guidelines A study involving 112 staff was performed in a DGH. Results showed poor overall recognition of any published guidelines (32%) with only six staff correctly identifying BTS guidelines. There was no difference between medical and surgical or consultant and junior staff in the management strategy. A tendency to initially over-treat the condition with invasive chest drainage rather than aspiration was noted. Also, there was a tendency to underestimate the size of collapse using percentages. The need for greater appreciation of detection and management of this common condition remains extant and must be addressed aggressively.