A patient presents to the ER after a A with multiple rib injuries. He is conscious, speaking single words. RR = 40/min, BP= 90/40 mmHg. What is the next immediate step in management?
(A) Intubate the patient (B) Urgent fluid infusion (C) Chest X ray (D) Needle inseion in 2nd ICS
(D) Answer- D. Needle inseion in 2nd ICSThis is a case of tension pneumothorax. Although the new ATLS update is 5th intercostal space in mid maxillary line, but in this question we will go with a time tested method of needle in 2nd intercostal space.