5th September 2020

A 25-year-old man presents to ED feeling breathless with sharp left-sided chest pain.

A 25-year-old man presents to ED feeling breathless with sharp left-sided chest pain. The symptoms started suddenly around an hour previously and he has never had anything like this before. He is normally fit and well and has no past medical history of note. He is a non-smoker. His vital signs are heart rate 80, respiratory rate 26, blood pressure 116/80, O₂ saturations 96% and temperature 36.7°C. On examination, the trachea is central and there are reduced breath sounds over the left lung. Chest x-ray shows an area without lung markings over the left upper lung, with a rim of air of 3cm.

What is the most appropriate initial management option?

Select the SINGLE most appropriate option from the list below. Select ONE option only.