Which intervention may be required in severe pneumothorax?

• A. Chest tube insertion may be required
• B. Antibiotics
• C. Physical therapy
• D. Observation only

Answer: (A)

In a severe pneumothorax, the air in the pleural space compresses the lung, compromising breathing. The priority is to remove that air and allow the lung to re-expand. Chest tube insertion, or tube thoracostomy, provides a controlled exit for the trapped air and lets the lung re-expand, improving ventilation and oxygenation. In a tension pneumothorax, this is an emergency: after immediate temporary relief with needle decompression, a chest tube is placed to continuously evacuate air and prevent recurrence. Antibiotics aren’t routinely needed unless there’s an infection, physical therapy isn’t an acute treatment, and observing the patient alone isn’t appropriate for a severe case because the lung remains collapsed if the air isn’t evacuated.