J. Harvey

< Symptoms in PSP may be minimal or absent. In contrast, symptoms are greater in SSP, even if the pneumothorax is relatively small in size. (D) < The presence of breathlessness influences the management strategy. (D) < Severe symptoms and signs of respiratory distress suggest the presence of tension pneumothorax. (D) The typical symptoms of chest pain and dyspnoea may be relatively minor or even absent, 23 so that

These guidelines have been replaced by BTS Pleural Disease Guideline 2010 Superseded By BTS Pleural Disease Guideline 2010: BTS Guidelines for the Management of Pleural Disease. Thorax 2003 May; 58(Suppl 2): 1–59.

patients starting second line drug treatment who require faster correction of their anaemia than would be achieved by the modifying effect on the disease of such drugs.We thank Cilag for providing the human recombinant erythropoietin and matching placebo; metrologists Anne Thomson (Glasgow), Frances McEvoy (Belfast), and Gwynneth Clarke (Eastbourne); Dorothy McKnight for help with computing; and Professor R D Sturrock and Drs A Zoma and Max Field for allowing us to include their patients in the study.

Simple flow diagrams, with explanatory notes, have been devised to assist in the immediate and subsequent management of patients presenting to casualty departments with spontaneous pneumothorax. They cover decision making about which patients require admission; whether a drainage procedure is necessary; if so, the appropriate method, including technical details; inpatient treatment; referral of inpatients to a respiratory specialist; and follow up arrangements. The guidelines, designed for incorporation into casualty and ward handbooks, have already proved valuable in several district general hospitals, and can be used as a basis for audit.