A 29-year-old man is brought as triage level 1 after a motorcycle crash. He is cyanotic with BP 70/38 mm Hg, absent right breath sounds, distended

Question

A 29-year-old man is brought as triage level 1 after a motorcycle crash. He is cyanotic with BP 70/38 mm Hg, absent right breath sounds, distended neck veins, and tracheal deviation left. Bag-valve-mask ventilation is difficult. Which of the following is the most appropriate initial action?

Accepted Answer

Immediate right-sided finger or needle thoracostomy

Answer

Portable chest radiograph before decompression

Answer

Pericardiocentesis as first procedure

Answer

CT chest with IV contrast

Answer

Bilateral tube thoracostomy after FAST examination

Tension pneumothorax — ABEM Board MCQ

A 29-year-old man is brought as triage level 1 after a motorcycle crash. He is cyanotic with BP 70/38 mm Hg, absent right breath sounds, distended neck veins, and tracheal deviation left. Bag-valve-mask ventilation is difficult. Which of the following is the most appropriate initial action?