QuestionSBA
QuestionChoice
Correct. This is the immediate management needed as it is suspected that this patient has a tension pneumothorax. ATLS guidelines now recommend accessing the 5th intercostal space mid-axillary line in **traumatic** tension pneumothorax following studies that have shown improved success in reaching the thoracic cavity when the 4th or 5th intercostal space in the mid-axillary line is used instead of the 2nd intercostal space in the mid-clavicular line in adult patients. 
10002916
a
Needle decompression at the fifth intercostal space, mid-axillary line
QuestionChoice
Incorrect. This would likely be management at a later stage, however as this patient has a tension pneumothorax it needs urgent decompression.
10002917
b
Chest drain
QuestionChoice
Incorrect. This patient has a tension pneumothorax and needs immediate management. A patient with asymptomatic pneumothorac may be admitted for observations without any immediate management.
10002918
c
Admit for observations
QuestionChoice
Incorrect. This patient has a suspected tension pneumothorax, meaning a chest X-ray is unnecessary.
10002920
e
Chest X-Ray
QuestionChoice
Incorrect. This is the correct management plan but in the incorrect location.
10002919
d
Needle decompression at the second intercostal space, mid-axillary line
Concept
Chapter
2693
3899
Pneumothorax
Topic
132
Respiratory
13130
A 24 year old male patient presents with a stab wound to the chest. On examination they have tracheal deviation and oxygen saturations of 94%.

What is the **first** step in management of this patient?
a