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?
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
Sta IV fluids after inseion of wide bore IV line
Needle decompression in the 5th intercostal space
Shift to ICU and intubate
Positive pressure ventilation
NEET Jan 2020