A patient in pulseless electrical activity after a road collision has distended neck veins, absent breath sounds on the left and a deviated trachea. Which treatment addresses the most likely reversible cause?
Answer and explanation
Correct answer: B. Decompression of the left chest with a needle or finger thoracostomy
- Step 1: Distended neck veins, absent unilateral breath sounds and tracheal deviation point to a tension pneumothorax, one of the reversible causes of arrest. Step 2. Tension pneumothorax is a clinical diagnosis and is treated at once by decompression, not after imaging. Answer: Decompression of the left chest with a needle or finger thoracostomy. Why not the others: Pericardiocentesis treats tamponade, which would not give absent breath sounds or a deviated trachea. Fluids do not relieve the obstruction to venous return. Waiting for an X-ray wastes time and positive pressure ventilation would worsen the tension.
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