skip to main content

Tension pneumothorax (traumatic arrest) — DIPIMC MCQ

Instant feedback + full explanation. One question, done properly.

HardPre-Hospital TraumaTension pneumothorax (traumatic arrest)DIPIMCDipIMC

A 24-year-old stabbed in the left chest deteriorates to a peri-arrest state and is intubated by the HEMS team. Ventilation becomes progressively harder with rising airway pressures, breath sounds are absent on the left, the neck veins are distended and the trachea is deviated to the right. SpO2 is unrecordable.

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: B — Perform bilateral finger thoracostomies

Explanation lettering: D = shown as A · A = shown as C · E = shown as D · C = shown as E

In an intubated, positively ventilated or arresting trauma patient, finger thoracostomy is the pre-hospital standard for relieving a tension pneumothorax because it is reliable and not limited by chest-wall thickness or catheter kinking; it is performed bilaterally in traumatic cardiac arrest. Needle decompression (A) frequently fails in this setting and is better suited to a spontaneously breathing patient. A chest seal (D) is for an open wound, not a closed tension. Always relieve tension surgically when the patient is ventilated.

Reference: Resuscitation Council UK 2025 (traumatic cardiac arrest); ATACC