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Management of spontaneous pneumothorax using a Heimlich flutter valve

Intrapleural evacuation of air was achieved with a Heimlich flutter (non-return) valve in 16 patients with a total of 18 pneumothoraces, 17 of which were spontaneous. Complete lung expansion occurred in 17 (94·4%) of these episodes by five days, and 12 (66%) showed full expansion within one hour. Valve blockage occurred in one patient whose pneumothorax was associated with exudation through the intrapleural catheter and standard under water drainage is recommended in this situation or where there is effusion. The flutter valve precludes the need for the cumbersome apparatus of under water seal drainage and therefore avoids the well-known possible dangers of connecting an intrapleural catheter to a water trap. Another advantage is the immediate mobility of the patient.