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Table 1 Summary of the BTS and ACCP guidance on the management of primary spontaneous pneumothorax

From: A need to reconsider guidelines on management of primary spontaneous pneumothorax?

  Size of pneumothorax BTS ACCP
Stablea and asymptomatic Small No intervention No intervention
Large 1. Needle aspiration
If fails
2. Intercostal chest drain
Intercostal chest drain
Unstable or breathless NA 1. Needle aspiration
If fails
2. Intercostal chest drain
Intercostal chest drain
  1. aStable fulfilling all criteria - Respiratory rate <24 breaths/min; heart rate 60–120 bpm; O2 saturation >90% on room air; blood pressure >90/60; able to complete full sentences between breaths