How can you decompress a tension pneumothorax in a field setting?

To decompress a tension pneumothorax in a field setting, identifying the site and performing needle decompression is critical. A tension pneumothorax occurs when air enters the pleural space and creates pressure that collapses the lung and impedes blood flow to the heart. This situation is life-threatening and requires immediate intervention.

Needle decompression involves inserting a large-bore needle into the pleural space, typically at the second intercostal space in the midclavicular line, to allow trapped air to escape. This reduces pressure in the chest cavity, allowing the lung to re-expand and improving cardiac output and respiratory function.

Other approaches listed—such as performing CPR, encouraging deep breaths, or waiting for help—do not address the immediate need to relieve the pressure in the pleural cavity. CPR might be necessary if the patient is unresponsive or not breathing, but it does not resolve the tension pneumothorax. Encouraging deep breaths could exacerbate the situation by increasing pressure in the thoracic cavity. Waiting for help could lead to rapid deterioration in the patient's condition, making timely intervention crucial.