A patient came with chest trauma and tachypnea (RR >40) and after check-up he had hypertension (BP = 90/60) and hyper resonant note on the involved side. What will be the next step?
Intubate
CXR
IVF
Wide bore needle insertion on 2nd ICS
Ans. D. Wide bore needle insertion on 2nd ICSThis is a case tension pneumothorax.* It is a case of typical tension pneumothorax.* Management: Immediately place a large-bore needle (preferably 14G/12G) or IV catheter into the pleural space at the second ICS on the involved side. Then place a chest tube.* Now the guideline has changed from second ICS to fifth ICS. But it does not mean that it should not be done in second ICS. Best is 5th ICS > 2nd ICS.
Respiratory