Prehospital Trauma Life Support (PHTLS) Practice Test

The immediate management step for a tension pneumothorax involves performing needle decompression to alleviate the pressure within the pleural space. A tension pneumothorax occurs when air enters the pleural space and cannot escape, creating increased pressure that compromises respiratory function and circulation. This elevated pressure can lead to significant cardiovascular and respiratory distress, necessitating swift intervention.

Needle decompression involves inserting a large-bore needle into the second intercostal space in the midclavicular line on the affected side to allow trapped air to escape. This procedure relieves the pressure, re-expands the lung, and restores normal hemodynamics, which is critical for the patient’s survival.

The other options, while part of initial trauma management, do not address the immediate life-threatening condition posed by a tension pneumothorax. Administering high-flow oxygen may be necessary later to manage hypoxemia but does not resolve the pneumothorax. Securing the airway is vital in many trauma patients but does not directly treat the tension pneumothorax. Performing chest physiotherapy is not appropriate as it does not address the acute pressure situation caused by the air in the pleural space. Therefore, needle decompression is the critical immediate step that must be