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Tension pneumothorax — DipIMC MCQ

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ModerateTraumaTension pneumothoraxDipIMC

A trapped 41-year-old driver is ventilated with a bag-valve-mask after a side impact. He becomes hypotensive with absent left breath sounds, distended neck veins and increasing ventilatory resistance. What is the most appropriate immediate action?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: D — Perform immediate left-sided thoracic decompression

Perform immediate left-sided thoracic decompression is the best answer because this is obstructive shock from likely tension pneumothorax and decompression is time-critical. Delay intervention until arrival at hospital is less appropriate because delay is unsafe when a reversible pre-hospital threat is present; Perform a full secondary survey before treating the abnormality is less appropriate because secondary survey follows correction of immediate life threats. Give a large crystalloid bolus before controlling the injury and Wait for imaging before intervening are also suboptimal because they move attention away from the key pre-hospital priority.. The key DipIMC principle is to treat immediate reversible threats, communicate clearly and move the patient toward the right definitive care.

Reference: JRCALC Guidelines; ATACC Manual; NICE Major Trauma NG39