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The recent update on pneumothorax by Currie et al1 mis‐cites a recent review on tension pneumothorax.2 This review of tension pneumothorax specifically questions the classical understanding of the condition with emphasis on the following points.
Ventilated and awake patients present with totally different features as follows: Awake—sudden onset but with gradual decompensation that may take less than 60 min but can take many hours with chest pain, respiratory distress, tachycardia, tachypnoea, desaturation and variable ipsilateral signs of pneumothorax, chest hyperexpansion and hypomobility. Hypotension is rare and late in the disease process with final demise being respiratory arrest that precedes cardiac arrest. Ventilated—sudden presentation at time of decompensation with desaturation, marked hypotension and variable signs of pneumothorax, surgical emphysema or high airway pressures.
The lack of usefulness of tracheal deviation is emphasised in the article along with the potential for decompression to fail or cause iatrogenic harm.
A correction has been published in the journal to avoid incorrect citation in future.
Competing interests: none declared