Supplemental oxygen with non-rebreather for all
Immediate needle thoracostomy followed by chest tube
Cover wound with three-sided dressing
Make sure to avoid complete occlusion (may convert injury to a tension pneumothorax)
Make sure to avoid complete occlusion (may convert injury to a tension pneumothorax)
Tube thoracostomy indicated if:
Cannot be observed closely
Requires intubation
Will be transported by air or over a long distance
Observation if:
Very small AND does not require mechanical ventilation
Unchanged on repeat CXR in 6 hours
Decision to intubate
Intubation can lead to positive pressure which may worsen a stable<unk> 
If patient stable, preferable to just perform thoracostomy
If GCS < 8 or patient having difficulty, they should be intubated
Cannot be observed closely
Requires intubation
Will be transported by air or over a long distance
Very small AND does not require mechanical ventilation
Unchanged on repeat CXR in 6 hours
Intubation can lead to positive pressure which may worsen a stable<unk> 
If patient stable, preferable to just perform thoracostomy
If GCS < 8 or patient having difficulty, they should be intubated
Most spontaneous pneumothorax (primary and secondary)
Most iatrogenic pneumothorax
Alveolar-pleural fistulae (small air leak)
Iatrogenic air<unk><unk>  hemothorax ("any acute hemothorax visible on chest radiograph")
Pneumothorax on mechanical ventilation
Non-traumatic tension pneumothorax
Malignant effusion
Trauma/bleeding (hemothorax/hemopneumothorax)
Bronchial-pleural fistulae (large air leak)
Malignant fluid
Empyema
Thick pus
Traumatic pneumothorax
Tension pneumothorax
Spontaneous pneumothorax
Hemothorax
Catamenial pneumothorax
Pulmonary contusion
Iatrogenic pneumothorax
Chylothorax