Spontaneous Pneumothorax: Clinical Assessment and Emergency Management for Paramedics and Emergency Healthcare Professionals

Abstract

Background: Spontaneous pneumothorax is a common respiratory emergency characterized by the accumulation of air within the pleural cavity without preceding trauma or iatrogenic injury. It is classified into primary spontaneous pneumothorax (PSP), occurring in individuals without clinically evident lung disease, and secondary spontaneous pneumothorax (SSP), which develops in association with underlying pulmonary disorders. Aim: This review aimed to provide a comprehensive overview of spontaneous pneumothorax, focusing on its etiology, epidemiology, pathophysiology, clinical presentation, diagnostic evaluation, contemporary management strategies, and prognosis among emergency healthcare professionals and paramedics. Methods: A narrative literature review was conducted using current evidence and contemporary clinical guidelines addressing spontaneous pneumothorax. The review synthesized information regarding disease mechanisms, risk factors, diagnostic approaches, treatment recommendations, and long-term outcomes from published epidemiological studies and professional society guidelines. Results: Spontaneous pneumothorax predominantly affects young men in PSP and older patients with underlying lung disease in SSP. Diagnosis relies on clinical assessment supported by chest radiography, ultrasonography, and computed tomography when indicated. Management ranges from conservative observation and oxygen therapy in stable patients to needle decompression, tube thoracostomy, chemical pleurodesis, and video-assisted thoracoscopic surgery in more severe or recurrent cases. Conclusion: Spontaneous pneumothorax remains an important cause of acute respiratory distress requiring prompt recognition and individualized management. Advances in diagnostic imaging and evolving treatment strategies have improved patient outcomes. Early diagnosis, appropriate intervention, and recurrence prevention remain critical components of effective care, particularly in patients with secondary disease and high-risk clinical features.