If tension pneumothorax is suspected, what intervention is indicated?

• A. Needle thoracostomy
• B. Chest x-ray before procedure
• C. Observation only
• D. Oxygen therapy alone

Answer: (A)

Relieving the life-threatening pressure immediately is the key when tension pneumothorax is suspected. In this situation, air builds up under high pressure in the pleural space, collapsing the affected lung and shifting the heart and great vessels to the opposite side. That shifting compresses venous return to the heart and can cause rapid deterioration into shock.

Because every second counts, you don’t wait for imaging to confirm the diagnosis. Imaging or observation won’t relieve the trapped air or the mediastinal shift. Oxygen helps with hypoxia but does not fix the underlying pressure or lung collapse.

Needle thoracostomy provides rapid decompression by allowing the trapped air to escape, immediately reversing the tension and stabilizing the patient. After decompression, a chest tube is placed for ongoing drainage and re-expansion of the lung.