<prompt> A case of spontaneous pneumothorax comes to you. What will be the earliest tt of choice -IPPVNeedle aspirationICDWait and watch  <response>: Pneumothorax: is the presence of gas in the pleural space.Types :a Spontaneous pheumothorax is one that occurs without antecedent trauma to the thoraxi Primary spontaneous - Occurs in the absence of an underlying lung disease usually dt apical plural blebs.ii Secondary spontaneous - dt an underlying lung disease.Traumatic pneumothorax results from penetrating or non-penetrating injuries to the chest.Tension pheumothorax Any pneumothorax in which the pressure in the pleural space is positivethroughout the respiratory cycle.In this pt. its not specified the type of spontaneous pneumothorax; still, lets see the ttTreatmentPrimary spontaneous pneumothoraxInitial recommended treatment is a simple aspirationIf the lung does not expand with aspiration, or if the pt. has a recurrent pneumothorax, thoracoscopy with stapling of blebs and pleural abrasion is indicated 100 success rateSecondary Spontaneous pneumothoraxSec. spon. pneumothorax can occur in any lung ds but are commonly seen in COPD.Nearly all pts are tt with tube thoracostomy and the installation of a sclerosing agent such as doxycycline or talc.Pts. with a persistent air leak, an unexpanded lung after 3 days of tube thoracostomy, or a recurrent pneumothorax should be subjected to thoracoscopy with bleb resection and pleural abrasion.Traumatic pneumothoraxTraumatic pneumothorax should be tt with tube thoracostomy unless they are very small. If a hemopneumothorax is present, one chest tube should be placed in the superior part of the hemithorax to evacuate the air, and another should be placed in the inferior part of the hemithorax to remove the blood.Tension pneumothoraxIt is an emergency situation.A large bore needle is inserted into the pleural space through the Second anterior intercostal space. The needle should be left in place until a thoracostomy tube is inserted.I assume that the pt. has primary spontaneous pneumothorax as there is no past history of any disease. 