Spontaneous pneumothorax in association with a major burn.

We report a case of a spontaneous pneumothorax in association with a major burn. The pneumothorax remained undetected for 4 days and the patient underwent a 2 h aeromedical transfer which could potentially have been hazardous. We strongly recommend that arterial blood gas analysis is performed before air transport of moderate or severely burned patients. If blood gases are abnormal a chest X-ray should also be performed. In practice a strong case can be made for routinely obtaining a chest X-ray in these patients. In-flight monitoring should include pulse oximetry.