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Tension pneumothorax — DipIMC MCQ

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EasyPre-Hospital Trauma ManagementTension pneumothoraxDipIMC

A 35-year-old cyclist has been struck by a car. He is tachypnoeic, has reduced left-sided chest movement, distended neck veins and a systolic blood pressure of 78 mmHg. What is the most appropriate immediate action?

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Correct answer: B — Perform immediate chest decompression for suspected tension pneumothorax

The combination of severe respiratory compromise and haemodynamic instability after chest trauma is consistent with tension pneumothorax, which requires immediate decompression. Imaging must not delay treatment in an unstable patient. A dressing is relevant to open pneumothorax, not a closed tension physiology. The pearl is that pre-hospital pneumothorax intervention is based on clinical assessment when delay risks arrest.

Reference: NICE Major Trauma NG39; JRCALC Guidelines 2025