[Prehospital diagnostic errors and therapeutic policy in spontaneous pneumothorax]

The authors analyze diagnostic and tactical errors in rendering prehospital emergency and outpatient care for spontaneous pneumothorax (SP). Delay in hospitalization to thoracal department threatens intrapleural complications, makes treatment more difficult and durable. SP was diagnosed as primary in 510 of 615 SP cases (576 patients). 105 SP episodes occurred in patients with bronchopulmonary diseases (secondary SP). Accurate diagnosis was made immediately or after a short examination in 431 patients, misdiagnosis took place in 194 patients (31.04%). Secondary and primary SP was missed in 39.4 and 29.4% of patients, respectively. Primary SP was mistaken for extrapulmonary affection (intercostal neuralgia, ischemic heart disease, osteochondrosis, etc), while secondary SP was misdiagnosed as progression or onset of bronchopulmonary diseases.