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EasyRespiratoryTension pneumothoraxuk-plab-1

A 25-year-old man is brought to the emergency department after a road traffic collision. He is agitated and complaining of severe right-sided chest pain and breathlessness. Observations: RR 34/min, HR 140 bpm, BP 85/60 mmHg, SpO2 88% on high-flow oxygen. Trachea is deviated to the left, there is hyper-resonance and absent breath sounds on the right. What is the most appropriate immediate management?

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