A young male met with A, the patient is dyspnoea on auscultation breath sounds are absent on right side and has hypotension. What is immediate next step?: (A) Urgent IV fluid administration, (B) Intubate the patient, (C) Chest X-ray, (D) Needle inseion in 5th intercostal space
Answer is D. Clinical history is suggestive of diagnosis of Tension Pneumothorax Conscious + Speaking Single words Dyspnoea Tachypnea Low BP Absent breath sound on one side Management: Clinical dx with dire emergency: T/t should be never delayed for radiological confirmation. Hence, CXR is not performed. T/t of choice: Intercoastal Chest Tube inseion - 5th ICS (Triangle of Safety) in anterior axillary lines