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Tension pneumothorax — DIPIMC MCQ

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

HardPre-Hospital TraumaTension pneumothoraxDIPIMCDipIMC

You are managing an intubated, ventilated trauma patient during transfer. Oxygen saturations fall to 80%, the right chest is hyper-resonant with absent breath sounds, ventilation pressures are rising and the blood pressure is dropping. A 14-gauge cannula placed in the second intercostal space hisses briefly but the patient does not improve. What is the most appropriate next step?

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

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Correct answer: D — Perform a finger thoracostomy on the affected side

Needle decompression frequently fails in adults because the cannula is too short or kinks, and in a ventilated patient a simple finger thoracostomy reliably decompresses a tension pneumothorax. A further needle repeats an unreliable technique, and imaging wastes time in a peri-arrest situation. Adjusting ventilation or oxygen does not relieve the trapped intrapleural air. Pearl: in ventilated patients, move quickly to thoracostomy rather than relying on a needle.

Reference: JRCALC Clinical Guidelines; Faculty of Pre-Hospital Care (RCSEd)