If patient is awake/alert, anesthetize the skin, muscle and down to pleura.
the "give" of the parietal pleura indicates access of the pleural space
if tension hemopneumothorax is present, you may hear a "whoosh" of air or note swift return of blood
intrapleural palpation confirms access of the pleural space
re-expansion of the lung parenchyma may be palpated, especially if patient is receiving positive pressure ventilation (e.g. intubated)
Finger thoracostomy
Needle thoracostomy
Thoracotomy
Thoracotomy 
Thoracic lavage
Pulmonary antibiotics
Surgical airways
Chest tube