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In reply:

      I appreciate the Letter to the Editor from Keijzers et al
      • Keijzers G.
      • Egerton-Warburton D.
      • Simpson G.
      Consider Conservative Approach Rather Than Intervening in Moderate to Large Spontaneous Pneumothorax.
       because it raises an excellent point querying whether intervention should be performed in the first place for most patients with primary spontaneous pneumothoraces. This is an important dilemma not yet definitively addressed in the literature and one that clinicians at the bedside face before the question that the article
      • Tupchong K.
      Update: is needle aspiration better than chest tube placement for the management of primary spontaneous pneumothorax?.
      attempts to answer.
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      References

        • Keijzers G.
        • Egerton-Warburton D.
        • Simpson G.
        Consider Conservative Approach Rather Than Intervening in Moderate to Large Spontaneous Pneumothorax.
        Ann Emerg Med. 2018; 72: 731-732
        • Tupchong K.
        Update: is needle aspiration better than chest tube placement for the management of primary spontaneous pneumothorax?.
        Ann Emerg Med. 2018; 72: e1-e2
        • Brown S.G.A.
        • Ball E.L.
        • Perrin K.
        • et al.
        Randomised controlled trial of invasive versus conservative management of primary spontaneous pneumothorax, a protocol.
        BMJ Open. 2016; 6: e011826

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