21st February 2025

A 19-year-old man attends A&E complaining of breathlessness.

A 19-year-old man attends A&E complaining of breathlessness. He has no past medical history and gives no history of any recent trauma.

His heart rate is 85 beats per minute, blood pressure 115/75 mmHg, respiratory rate 16/minute and oxygen saturations 97% on room air. Examination reveals reduced air entry on the right side of the chest and chest X-ray reveals a right-sided pneumothorax with a 3 cm rim of air.

A needle aspiration is carried out in A&E and following this, the patient reports his breathlessness has resolved. A repeat chest X-ray demonstrates the pneumothorax is now 1cm. 

What is the most appropriate next step in management?

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