A simple pneumothorax?

You are a GP doing your regular shift in the emergency department of your local hospital. According to the screen of waiting patients, the next patient to be seen has been classified as a category 3. This means the problem is not life-threatening and the patient can be seen in 30 minutes. Subconsciously you feel a bit more at ease because, as a GP, you still worry about the critically ill patients in spite of all the support that is readily available in the emergency department.

The patient

From the triage nurse’s assessment you see that the patient is a 24-year-old man who has had left-sided chest pain for the last two days on a background of recurrent pneumothoraces. It is noted that he is in no distress, and is able to walk and talk freely.