PAEA Surgery End Of Rotation (EOR) Practice Exam

What is the initial treatment approach for a pneumothorax?

1. Immediate surgery

2. Oxygen therapy and needle decompression

3. Rest and observation

4. Chest x-ray followed by antibiotics

The correct answer is: Oxygen therapy and needle decompression

The initial treatment approach for a pneumothorax typically involves oxygen therapy and needle decompression. This is because, in most cases of pneumothorax, the priority is to relieve the pressure in the pleural space and allow the lung to reinflate. When dealing with a pneumothorax, especially a tension pneumothorax, immediate intervention is critical. Oxygen therapy can help by promoting the reabsorption of the air in the pleural space while increasing the partial pressure gradient. In situations where the pneumothorax is causing significant respiratory distress or hemodynamic instability, needle decompression is performed to rapidly decompress the pleural space and restore normal intrathoracic pressure. Observation or rest may be appropriate in cases of small, uncomplicated pneumothoraces that are asymptomatic or minimally symptomatic, but this is not typically the immediate response to a pneumothorax. Additionally, while imaging such as a chest x-ray is necessary for diagnosis, it is not a treatment but rather a tool used before deciding on further management. Surgery is generally reserved for recurrent pneumothoraces or when other interventions have failed, making it not the initial approach. Hence, oxygen therapy combined with needle decompression is considered the appropriate initial treatment