Contributor: Adam Barkin, MD Educational Pearls: Multi-center open-label non-inferiority trial looked at treatment of pneumothorax with a small-bore chest tube versus conservative management with exceptional follow up 316 patients ages 14-50 with moderate to large pneumothorax (>32% measured on CXR) were randomized into one of the two treatment arms 15% of the conservative group required further intervention as determined by prespecified protocols 94.4% of the intervention group had resolution at 8 weeks, whereas 98.5% of the conservative group had resolution at 8 weeks These data were affected by poor follow up CXR resolution average of 16 days in the intervention group and 30 days in the conservative group Symptom resolution was similar between the two groups (median 15 days vs. 14 days) Recurrence at 12 months was 17% in interventional group vs 8% in conservative group 41 adverse events in intervention group and 13 adverse events in conservative group References Brown SGA, Ball EL, Perrin K, et al. Conservative versus Interventional Treatment for Spontaneous Pneumothorax. N Engl J Med. 2020;382(5):405-415. doi:10.1056/NEJMoa1910775 Franzen, D. (2019, November). Pneumothorax. Society of Academic Emergency Medicine. https://www.saem.org/about-saem/academies-interest-groups-affiliates2/cdem/for-students/online-education/m4-curriculum/group-m4-respiratory/pneumothorax. Summarized by John Spartz, MS4 | Edited by Erik Verzemnieks, MD The Emergency Medical Minute is excited to announce that we are now offering AMA PRA Category 1 credits™ via online course modules. To access these and for more information, visit our website at https://emergencymedicalminute.org/cme-courses/ and create an account.  Donate to EMM today!