A 30 year old female comes acute breathlessness, neck vein distention, and absent breath sounds and nediastinal shift. Which of the following should be done immediately?
Answer is D (Large Bore needle puncture of pleura): Acute breathlessness absent breath sounds, neck vein distension and mediastinal shift suggests a diagnosis of Tension Pneumothorax. Tension pneumothorax must be treated as a medical emergency and therapeutic intervention should not be delayed while waiting for investigations. Immediate puncture of pleura with a large bore needle through the second intercostal space is the treatment of choice.
HRCT is the investigation of choice
ABG analysis should be done
CXR
Large bore needle puncture of pleura