Prehospital Trauma Life Support (PHTLS) Practice Test

In cases of tension pneumothorax, what is often inadequately assessed?

1. Blood pressure

2. Heart rhythm

3. Respiratory rate

4. Neck vein distention

The correct answer is: Blood pressure

In cases of tension pneumothorax, the assessment of blood pressure can often be inadequate due to the rapidly progressing nature of the condition. Tension pneumothorax occurs when air enters the pleural space and cannot escape, leading to increased pressure that can collapse the lung and compress major blood vessels. This can result in decreased venous return to the heart, hypotension, and compromised cardiac output. When evaluating a patient with suspected tension pneumothorax, clinicians must focus on immediate indicators of hemodynamic stability. However, the urgency of securing the airway and decompressing the chest often shifts attention away from a thorough blood pressure assessment. Moreover, patients may show signs of cardiovascular shock even before a noticeable drop in blood pressure is detected. Thus, while blood pressure is crucial for understanding a patient's overall status, it may not receive the focus it needs during the critical moments of recognition and management of tension pneumothorax. In contrast, other assessments such as heart rhythm, respiratory rate, and neck vein distention may receive more immediate attention, as they can provide quicker insights into the patient's respiratory and circulatory status.