6th May 2024

A 35-year-old man, a smoker, presents to the emergency department with sudden onset of left-sided chest pain and shortness of breath after lifting heavy boxes.

A 35-year-old man, a smoker, presents to the emergency department with sudden onset of left-sided chest pain and shortness of breath after lifting heavy boxes. He has no past medical history and takes no regular medications. On examination, his oxygen saturation is 92% on room air, heart rate is 110 beats per minute, and blood pressure is 130/85 mmHg. Auscultation reveals reduced breath sounds on the left side. A chest X-ray confirms a left-sided pneumothorax with a 2.5 cm rim of air between the lung margin and the chest wall.

Which is the most appropriate initial management for this patient?