Question

A 24-year-old man presents after a stab wound to the right chest. He is acutely breathless and agitated. Examination shows tracheal deviation to the left, distended neck veins, absent breath sounds on the right and hyper-resonance to percussion on the right. His blood pressure is 80/40 mmHg and pulse 140 bpm. What is the single most appropriate immediate management step?

Accepted Answer

Insert a large-bore cannula into the 2nd intercostal space in the mid-clavicular line on the right

Answer

Arrange an urgent chest CT scan before intervention

Answer

Request a portable chest X-ray to confirm the diagnosis

Answer

Give high-flow oxygen and await the trauma team before intervening

Answer

Insert an intercostal chest drain in the 5th intercostal space mid-axillary line under ultrasound guidance

Practice question