To drain or not to drain, that is the question

Spontaneous pneumothorax is an uncommon problem in childhood. However, it is frequent enough that most paediatricians will encounter this at some point in their careers. Traditional management for children and young people with a moderate to large pneumothorax has involved either needle thoracocentesis, chest drain insertion or both. However, recent clinical trials have suggested that a conservative approach may be possible and in some circumstances preferable to immediate intervention. This short article offers a suggested framework for management of spontaneous pneumothorax in children and young people.