Above clinical scenario suggestive of the diagnosis of Tension Pneumothorax In Tension pneumothorax, continuing leak causes increasing positive pressure in the pleural space, leading to compression of the lung, shift of mediastinal structures toward the contralateral side like kinking of Superior vena cava which cause decreases in venous return and cardiac output leading to hemodynamic instability like Hypotension. Staph is responsible for causing pneumatocele; so rupture ;ends to pneumothorax Treatment:- Immediate decompression + wide bore needle into 5th ICS - mid axillary line