DIET & NUTRITION 
PATIENT EDUCATION 
OBESITY/WEIGHT MANAGEMENT 
EXERCISE/TRAINING 
LEGAL MATTERS 
GUIDELINES/RECOMMENDATIONS Spontaneous pneumothorax strikes without obvious cause, most commonly in tall, thin young males with tobacco or cannabis use history. Tension pneumothorax, a rare but potentially fatal complication, demands immediate recognition and treatment.
Clinical Considerations
- Triage red flags include sudden pleuritic chest pain, diminished breath sounds, tachycardia, and O2 sat below 95%.
- Tension pneumothorax presents with hypoxia, tracheal deviation, and hypotension, requiring emergency intervention.
- High-flow 100% oxygen via non-rebreather mask is first-line treatment, accelerating gas reabsorption in the pleural space.
- Small, stable pneumothoraces can be managed with monitoring and serial chest x-rays; chest tube insertion is reserved for large or deteriorating cases.
Practice Applications
- Assess for diminished unilateral breath sounds, tachycardia, and hypoxia in any patient with sudden chest pain.
- Apply 100% oxygen via non-rebreather mask and initiate continuous cardiac and pulse oximetry monitoring immediately.
- Escalate immediately if patient develops hypotension, tracheal deviation, or worsening hypoxia — signs of tension pneumothorax.
- Educate discharged patients to avoid air travel and strenuous activity for one week and to return for worsening dyspnea or chest pain.
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