A 20 year old boy is brought to the emergency following a A with respiratory distress and hypotension. He has subcutaneous emphysema and no air entry on the right side. What is the next best step in the management?
Correct Answer: Needle decompression in the 5th intercostal space
Description: As the clinical scenario is suggestive of diagnosis of Tension Pneumothorax so according to ATLS 10th edition ??" Recent evidences suppo inseion of needle in 5th I/C space slightly anterior to MAL in Adults 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. Treatment: Immediate decompression + wide bore needle into 5th ICS ??' mid axillary line T/t of choice: Intercoastal Chest Tube inseion ??' 5th ICS (Triangle of Safety) in anterior axillary lines
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Surgery
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