Simple aspiration
It is done by a plastic iv canula instead of traditionally used needle which was associated with risk of laceration of lung. The site of second intercostals space in midclavicular line is conventional. It can also be performed in fifth intercostals space in anterior axillary line to prevent life threatening hemorrhage. Available literature of American College of Chest Physician (ACCP) and British Thoracic Society (BTS) says that the needle aspiration and/or small catheter insertion are effective, comfortable, safe, and economical alternatives to thorcostmy in selected patients