A trauma patient has severe respiratory distress, absent breath sounds on the right, a deviated trachea and low blood pressure. What should be done first?
Answer and explanation
Correct answer: B. Immediate needle decompression of the right chest, then a chest tube
- Step 1: Shock with absent breath sounds and tracheal deviation is a tension pneumothorax, a clinical diagnosis. Step 2. Pressure on the mediastinum is relieved by releasing air before imaging, because delay is fatal. Answer: immediate needle decompression. Why not the others: imaging and fluids both delay relief of the obstruction to venous return.
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