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EasyEmergencyTension pneumothoraxau-amcau-acem

A 27-year-old man is brought to the emergency department after a high-speed motor vehicle collision. He is distressed and dyspnoeic with right-sided pleuritic chest pain. On examination there is tracheal deviation to the left, absent breath sounds on the right and hyper-resonance to percussion. Blood pressure is 80/50 mmHg and pulse 130 bpm. What is the most appropriate immediate management?

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