11th January 2024

A 48-year-old gentleman with a history of emphysematous lung disease secondary to previous cannabis smoking presents to the emergency department with acute-onset shortness of breath and pleuritic chest pain.

A 48-year-old gentleman with a history of emphysematous lung disease secondary to previous cannabis smoking presents to the emergency department with acute-onset shortness of breath and pleuritic chest pain. He has asymmetrical chest expansion and reduced air entry on the left. His respiratory rate is 24 breaths/minute, and his oxygen saturations are 94% on 6L oxygen via a face mask. 

Investigations: 

Chest x-ray: 4cm L-sided pneumothorax. No mediastinal shift. 

What is the most appropriate management strategy for this presentation? 

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