A 35-year-old male was involved in a high-speed car accident. He is complaining of chest pain and difficulty breathing. On examination, there is decreased breath sound on the right side, and trachea is deviated to the left. What are the potential diagnoses, and what are the next steps?
This patient's history and physical examination findings are highly suggestive of a tension pneumothorax, a life-threatening condition where air enters the pleural space and cannot escape, leading to lung collapse and shifting of the mediastinum. Immediate needle decompression followed by chest tube insertion should be performed to relieve the pressure. Chest X-ray should be obtained afterward to confirm successful treatment.