Tension pneumothorax — DipIMC MCQ

Correct answer: C — Perform immediate chest decompression on the affected side

Explanation lettering: E = shown as A · A = shown as B · D = shown as C · B = shown as D · C = shown as E

D is correct: Obstructive shock with unilateral absent breath sounds after trauma is tension pneumothorax until proved otherwise and needs immediate decompression. A is less suitable because it creates avoidable delay in a time-critical presentation; B is less suitable because a detailed survey is inappropriate before correcting an immediate threat; C is less suitable because it moves the patient before the decisive threat or destination issue is addressed; E is less suitable because it does not address the discriminator in the vignette. The most tempting alternative is therefore suboptimal because it either delays the time-critical pre-hospital intervention or sends the patient to the wrong level of care. The key DipIMC principle is focused cABCDE decision-making with early pre-alert, triage or retrieval escalation when the scene physiology demands it.

Reference: JRCALC Guidelines; NICE Major Trauma NG39; ATACC