A 28-year-old man sustains blunt chest trauma in a road traffic accident. On examination, he has absent breath sounds on the left side, tracheal deviation to the right, hypotension, and distended neck veins. SpO2 is 82%. What is the immediate life-saving intervention?
- A Urgent chest X-ray
- B IV fluid resuscitation
- C Needle decompression in the 2nd intercostal space midclavicular line ✓
- D Pericardiocentesis
Correct answer: C. Needle decompression in the 2nd intercostal space midclavicular line
Explanation
Absent breath sounds, tracheal deviation away from the affected side, hypotension, and raised JVP are the classic findings of tension pneumothorax. This is a life-threatening emergency requiring immediate needle decompression at the 2nd intercostal space, midclavicular line on the affected side, without waiting for imaging. The tension pneumothorax compresses the mediastinum and great veins, causing obstructive shock. Pericardiocentesis treats cardiac tamponade (Beck's triad), which does not cause tracheal deviation or absent breath sounds.
Reference: Bailey & Love's Short Practice of Surgery, 27th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.