A 34 year old male with chest trauma presents with sudden onset respiratory distress which is increasing. Hyper-resonant note is observed on the left side. Which of the following is the most appropriate immediate emergent management?
Needle puncture and emergent decompression
Tube inseion
Antibiotic and oxygen
No treatment needed
Answer is A (Needle puncture and emergent decompression): Sudden Onset Respiratory Distress (which is increasing) and a Hyper-resonant percussion note in a patient with history of chest trauma suggest a diagnosis of Tension Pneumothorax. Needle puncture and emergent decompression is the treatment of choice for Tension Pneumothorax Tension pneumothorax must be treated as a medical emergency and therapeutic intervention should not be delayed while waiting for investigations. Immediate puncture of pleura with a large bore needle through the second intercostal space is the treatment of choice.