Questions

A 28-year-old male presents to the Emergency Department with sudden onset right-sided chest pain and mild shortness of breath following 3 days of upper respiratory tract infection symptoms. Chest X-ray shows a 2cm (at the hilum) pneumothorax on the right side.

Observations are HR 89, RR 18, saturations 98% on room air, BP 127/71, Temperature 36.8. The patient has no past medical history and wants to avoid a procedure.

Which is the most appropriate management plan?

Immediate needle aspiration
Chest drain insertion
Follow-up in 2-4 days
High-flow oxygen therapy and admission
Emergency thoracic surgery referral

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