Core EM - Emergency Medicine Podcast

Episode 213: Pneumothorax

Sep 1, 2025
Explore the intriguing world of pneumothorax, starting with its diverse risk factors and symptoms. Discover how to differentiate between serious conditions like asthma and pneumothorax. Learn about critical diagnostic tools, particularly the high efficacy of ultrasound in the emergency setting. The discussion also covers management strategies, advocating for simpler techniques like pigtail catheters over traditional chest tubes. This episode is packed with insights for optimal patient care in urgent situations!
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ANECDOTE

Fall Mistaken For Asthma

  • A 50-ish man with presumed asthma turned out to have unilateral absent breath sounds after a fall and chest crepitus.
  • Chris Pham diagnosed a traumatic pneumothorax that mimicked an asthma flare.
INSIGHT

Primary vs Secondary Pneumothorax

  • Everyone can get a pneumothorax, but classify them as primary or secondary to guide thinking.
  • Primary occurs spontaneously in young tall males or with underlying lung/connective tissue disease.
ADVICE

Look For Tension Red Flags

  • Use history and focused exam to differentiate pneumothorax from other causes of chest pain and dyspnea.
  • Watch for red flags of tension: JVD, tracheal shift, hypotension, severe tachycardia, or hypoxia.
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