After blunt trauma, an intubated patient becomes profoundly hypotensive and hypoxemic with absent right breath sounds and distended neck veins. A

Question

After blunt trauma, an intubated patient becomes profoundly hypotensive and hypoxemic with absent right breath sounds and distended neck veins. A 5-cm needle catheter placed anteriorly for suspected tension pneumothorax produces no clinical improvement. What should be done next?

Accepted Answer

Perform immediate right finger thoracostomy at the fourth or fifth interspace, followed by tube thoracostomy

Answer

Perform right finger thoracostomy at the second interspace in the midclavicular line, followed by tube thoracostomy

Answer

Perform bilateral finger thoracostomies at the fourth or fifth interspaces, followed by bilateral tube thoracostomies

Answer

Confirm absent right lung sliding with ultrasonography, then perform tube thoracostomy without prior finger decompression

Answer

Repeat needle decompression with an 8-cm catheter at the fifth interspace, then obtain radiography before tube placement

Tension pneumothorax — USMLE Step 3 MCQ

After blunt trauma, an intubated patient becomes profoundly hypotensive and hypoxemic with absent right breath sounds and distended neck veins. A 5-cm needle catheter placed anteriorly for suspected tension pneumothorax produces no clinical improvement. What should be done next?