patients had more than one unique consult due to recurrent disease on the same or contralateral side. There were 37 unique patients in the audit. These patients received initial fibrinolytic treatment (tPA + DNase). π8 F tube with an inbuilt Heimlich valve apparatus. †Two insertions were in the setting of secondary spontaneous pneumothoraces with acute respiratory failure and one insertion to palliate a concurrent large pleural effusion and an iatrogenic pneumothorax. Five insertions were in the postoperative setting; ΩRemoved in the ER (after pleurodesis confirmation) in the context of a Health Information Exchange alert about multiple area ER visits for a “nonfunctional catheter.” ßIBV Valve (Spiration, Redmond, WA, USA) is a unidirectional valve that blocks air entry distally and is inserted via a bronchoscopic procedure. In our series, all of them were inserted in prolonged air leaks due to secondary spontaneous pneumothoraces. Video assisted thoracoscopy. One of the episodes required an ambulatory 8 F chest tube. 2nd episode required hospital admission due to lack of credible follow-up. §Emergency room evaluation related to patient concerned about serosanguinous discharge into the ambulatory 8 F chest tube. ‡None of the dislodged chest tubes required reinsertion.