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Traumatic tension pneumothorax — RCPSC EM MCQ

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ModerateTraumaTraumatic tension pneumothoraxRCPSC EM

A 31-year-old motorcyclist arrives after a high-speed crash. He is cyanotic, hypotensive, and has absent breath sounds on the left with tracheal deviation to the right. Oxygen saturation is 78% despite high-flow oxygen. What is the most appropriate next step?

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Correct answer: D — Immediate left finger thoracostomy followed by chest tube

Tension pneumothorax is a clinical diagnosis in an unstable trauma patient. Immediate decompression is required before imaging, followed by definitive tube thoracostomy.

Reference: ATLS; Canadian trauma practice