Prehospital Trauma Life Support (PHTLS) Practice Test

Which key finding differentiates cardiac tamponade from tension pneumothorax?

1. Distended jugular veins

2. Equal breath sounds

3. Hypotension

4. Tachycardia

The correct answer is: Equal breath sounds

In assessing potential complications from traumatic injuries, differentiating cardiac tamponade from tension pneumothorax is crucial for proper management. The presence of distended jugular veins is particularly indicative of cardiac tamponade. This occurs due to increased intrathoracic pressure and compromised venous return to the heart. In contrast, tension pneumothorax often presents with unilateral, decreased, or absent breath sounds on the affected side due to the accumulation of air in the pleural space causing lung collapse. Equal breath sounds throughout both lung fields may occur in a patient with cardiac tamponade because the issue is centered around the heart and does not directly affect lung function in the same way as a pneumothorax does. Therefore, while hypotension and tachycardia can be common to both conditions, equal breath sounds specifically help to identify the lack of lung impairment, leading us to suspect cardiac tamponade rather than tension pneumothorax. By focusing on the distinction in breath sounds when recognizing these serious conditions, clinicians can make more informed decisions regarding immediate interventions and treatment pathways.