When should I consider referring a patient with a suspected tension pneumothorax to secondary care?

You should consider referring a patient with a suspected tension pneumothorax to secondary care immediately if they present with either haemodynamic instability or severe respiratory compromise NICE NG39. These are critical indicators for urgent intervention NICE NG39.

The optimal destination for patients with major trauma, which often includes conditions like tension pneumothorax, is typically a major trauma centre NICE NG39. In a hospital setting, chest decompression for tension pneumothorax is performed before imaging only if these life-threatening signs are present NICE NG39. Definitive management, such as performing chest decompression using open thoracostomy followed by a chest drain, is a secondary care intervention NICE NG39. Urgent imaging, like chest X-ray and/or eFAST, should be performed and interpreted immediately by a trained healthcare professional in secondary care NICE NG39.