A patient was stabbed in the chest with a serrated kitchen knife. He has a deviated trachea and now complains of chest pain. His blood pressure is 75/60 mmHg, the pulse is 122 bpm, and respiratory rate is 22/minute. What is the first treatment step?
Select Your Answer:
Tension pneumothorax is a life-threatening disorder that demands urgent treatment, even without a chest x-ray. If the tension pneumothorax is suspected, a needle decompression can be performed. The airway is slightly less of a priority because it is patent enough for the patient to complain and may still be required.
The needle placement is in the 2nd to 3rd intercostal space along the midclavicular line.
A thoracostomy tube is usually inserted after needle decompression.
Always get a follow-up chest x-ray to assess tube position in the chest and to ensure lung reexpansion.
*eMedicine, Google Scholar, UpToDate, WheelessOnline, and DermNet are not affiliated with StatPearls. We do not control their content or advertising.
Adult Lab Normals
Pediatric Lab Normals
Contralateral Traumatic Hemopneumothorax., Alexander QL,Andrés MA,Giovanni AL,Carlos HJ,David CJ,, Case reports in emergency medicine, 2018 [PubMed PMID: 30729046]
The Genetics of Pneumothorax., Boone PM,Scott RM,Marciniak SJ,Henske EP,Raby BA,, American journal of respiratory and critical care medicine, 2019 Jan 25 [PubMed PMID: 30681372]
An Analysis of Patients who Underwent Tube Thoracostomy in the Emergency Department: A Single Center Study., Kantar Y,Durukan P,Hasdıraz L,Baykan N,Yakar Ş,Kaymaz ND,, Turkish thoracic journal, 2019 Jan 1 [PubMed PMID: 30664423]
[Bilateral pneumothoraces in a pregnant woman following acupuncture - a case report]., Valgardsson AS,Gudbjartsson T,, Laeknabladid, 2019 Jan [PubMed PMID: 30601123]
A Case Report of Acute Airway Compromise due to Subcutaneous Emphysema., Olmstead D,Gelfand G,Anderson I,Kortbeek JB,, Case reports in medicine, 2018 [PubMed PMID: 30595698]