A case of traumatic pneumothorax during a commercial flight is reported, highlighting the need for medical professionals to adapt to unusual environments and equipment. The British Airways emergency medical kit includes 88 items, focusing on cardiac drugs and childbirth, but lacks sufficient surgical equipment. A 2% lignocaine 20 ml multidose vial has now been added to future kits. Traumatic pneumothorax has not previously been reported on flights, but survival is good if thoracic drainage is established before flight. This case shows the importance of innovation in using available materials for adequate chest drainage. The article discusses consensus methods in medical and health services research, emphasizing their role in decision-making when information is insufficient or conflicting. Two common methods are the Delphi process and the nominal group technique. The Delphi process involves multiple rounds of questionnaires to reach consensus, while the nominal group technique uses structured meetings to gather expert opinions. Both methods allow for the inclusion of a wide range of information and can be used when published data is inadequate. The article also discusses the validity and applicability of consensus methods, noting that while they are not a replacement for rigorous scientific research, they can help identify current medical opinions and areas of disagreement. The Delphi method has been criticized for not meeting scientific standards, but it remains a useful tool for generating quantitative estimates. The nominal group technique is often used for structured discussions and can be adapted for various settings. The article concludes that consensus methods provide a useful way to identify and measure uncertainty in medical and health services research. They have been used to clarify issues in health service organization, define professional roles, aid educational program design, and develop criteria for the appropriateness of interventions. These methods are often used as components of larger projects and can lead to the development of consensus statements that guide health policy, clinical practice, and research. The ultimate aim of consensus activities is the dissemination and implementation of findings.A case of traumatic pneumothorax during a commercial flight is reported, highlighting the need for medical professionals to adapt to unusual environments and equipment. The British Airways emergency medical kit includes 88 items, focusing on cardiac drugs and childbirth, but lacks sufficient surgical equipment. A 2% lignocaine 20 ml multidose vial has now been added to future kits. Traumatic pneumothorax has not previously been reported on flights, but survival is good if thoracic drainage is established before flight. This case shows the importance of innovation in using available materials for adequate chest drainage. The article discusses consensus methods in medical and health services research, emphasizing their role in decision-making when information is insufficient or conflicting. Two common methods are the Delphi process and the nominal group technique. The Delphi process involves multiple rounds of questionnaires to reach consensus, while the nominal group technique uses structured meetings to gather expert opinions. Both methods allow for the inclusion of a wide range of information and can be used when published data is inadequate. The article also discusses the validity and applicability of consensus methods, noting that while they are not a replacement for rigorous scientific research, they can help identify current medical opinions and areas of disagreement. The Delphi method has been criticized for not meeting scientific standards, but it remains a useful tool for generating quantitative estimates. The nominal group technique is often used for structured discussions and can be adapted for various settings. The article concludes that consensus methods provide a useful way to identify and measure uncertainty in medical and health services research. They have been used to clarify issues in health service organization, define professional roles, aid educational program design, and develop criteria for the appropriateness of interventions. These methods are often used as components of larger projects and can lead to the development of consensus statements that guide health policy, clinical practice, and research. The ultimate aim of consensus activities is the dissemination and implementation of findings.