Your elderly patient has been in a car accident and is feeling a little breathless, with pain on the right side of their chest. Their chest X-ray (CXR) shows a small pneumothorax, with some blunting of the costophrenic angle that might just be blood... What is the next step? Surgical chest drain or Seldinger technique? What size of tube is best? And do they even need urgent intervention?

Tube thoracostomy (insertion of a chest drain or tube) has been used to drain pus and excess air from the chest since ancient times. Over the last 100 years, we have gradually moved from large metal tubes to smaller flexible ones. Small-bore tubes were initially used in children, but are now becoming the norm across all age groups.

I was lucky to have trauma surgeon and cardiothoracic specialist Dr Irphan Yonis with me on the show this week to discuss this topic, as well as other related issues in the current management of chest trauma.