11th January 2024

A 91-year-old lady is admitted to hospital with worsening shortness of breath on a background of known metastatic squamous cell lung carcinoma with previous pleural effusions as a consequence of the disease.

A 91-year-old lady is admitted to hospital with worsening shortness of breath on a background of known metastatic squamous cell lung carcinoma with previous pleural effusions as a consequence of the disease. She is bedbound, has carers four times a day at home to help with all personal care needs and is known to the palliative care team. She is unable to talk in full sentences as she is so short of breath. On examination, you note a trachea deviated to the left, dullness to percussion throughout the right hemithorax, and reduced breath sounds on the right too. 

Given the likely diagnosis, which of the following is the most appropriate management strategy? 

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