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Tension pneumothorax — RACP Adult Medicine MCQ

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EasyRespiratoryTension pneumothoraxRACP Adult Medicine

A 36-year-old man becomes suddenly breathless after a motorbike crash. He is hypotensive, tachycardic and has reduced breath sounds on the left with tracheal deviation to the right. Oxygen saturation is 86% despite high-flow oxygen. What is the most appropriate management?

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Correct answer: B — Immediate needle decompression followed by intercostal catheter insertion

This is tension pneumothorax with shock, requiring immediate decompression before imaging. A chest drain follows definitive pleural decompression. Waiting for radiography, treating bronchospasm or arranging CT would delay life-saving treatment.

Reference: ANZ trauma guidelines; Therapeutic Guidelines (eTG)