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Tension pneumothorax after penetrating trauma — DipIMC MCQ

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ModerateTraumaTension pneumothorax after penetrating traumaDipIMC

A 32-year-old man has a left-sided stab wound outside a nightclub. He is pale and agitated with SpO2 88% on high-flow oxygen, respiratory rate 34/min, systolic blood pressure 78 mmHg, distended neck veins and markedly reduced air entry on the left. What is the most appropriate immediate action?

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Correct answer: A — Immediate left-sided thoracostomy or needle decompression

Obstructive shock from a tension pneumothorax is a clinical diagnosis and must be decompressed before transport. A dressing alone may help an open chest wound but will not relieve tension physiology. Fluid or transfer without decompression delays treatment of a reversible cause of peri-arrest.

Reference: JRCALC Guidelines; FPHC chest injury consensus; Resuscitation Council UK traumatic cardiac arrest