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Tension pneumothorax — SCE Respiratory MCQ

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HardPleural DiseaseTension pneumothoraxSCE Respiratory

A 61-year-old man with severe COPD suddenly becomes hypotensive and severely breathless on the ward. Examination shows tracheal deviation to the left, absent right breath sounds and distended neck veins. SpO2 is 84% on high-flow oxygen. What is the most appropriate management?

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Correct answer: C — Immediate right-sided needle decompression followed by chest drain

This is a tension pneumothorax with obstructive shock, requiring immediate decompression before imaging. Waiting for CT could be fatal. Diuretics and diagnostic aspiration do not relieve the pressure physiology.

Reference: BTS Pleural Disease Guideline 2023; Resuscitation Council UK ALS