Current practice and attitudes in emergency department management of primary spontaneous pneumothorax in Australia and New Zealand: a scenario‐based/survey

作者：Anne‐Maree Kelly, Sanjeevan Muruganandan, Peter Jones, Gerben Keijzers, Fran Kinnear, Peter J‎. Cameron, Arash Badiei, Gary Lee, Julian A. Smith, Emma L Ball, Ethan Bacon, Roland Bammer, Diana Egerton‐Warburton · 发表于：Internal Medicine Journal · 年份：2025 · DOI：10.1111/imj.70054 · 被引用次数：3 · 研究领域：Pleural and Pulmonary Diseases、Ultrasound in Clinical Applications、Occupational and environmental lung diseases

BACKGROUND: Management of primary spontaneous pneumothorax (PSP) has long been contentious. AIMS: To identify the factors influencing interventional versus conservative management and to assess current practice patterns for moderate-to-large PSP in emergency department (ED) patients. METHODS: Anonymous online survey of emergency medicine, respiratory medicine and thoracic surgery specialists and trainees in Australia and New Zealand. Data collected included rating the decision-making importance of potential drivers of interventional versus conservative management for PSP, initial management preference for stable patients with moderate-large PSP based on three X-ray-based scenarios (one moderate-large, one almost total collapse without mediastinal shift and one large with mediastinal shift) and awareness of evidence and current guidelines for the management of PSP. RESULTS: There were 456 responses; 85.5% were from Australia. The most commonly reported factors influencing treatment decision-making were vital signs (96.7%) and patient-reported dyspnoea (84.3%). There was variation between specialty groups in initial treatment preference for all scenarios (P < 0.001) and a reduction in preference for conservative treatment as the magnitude of radiological features increased (93.8% vs 61.5% vs 32.1% respectively). Guideline recommendation awareness was low except for the 2023 British Thoracic Society guideline (60.4%). CONCLUSION: This study demonstrates variation of opinion rega...