What is the appropriate treatment for a tension pneumothorax?

Tension pneumothorax is a life-threatening condition that occurs when air enters the pleural space and cannot escape, leading to increased pressure that collapses the lung on the affected side and can hinder circulation. The appropriate treatment involves immediate actions to relieve this pressure.

Needle decompression is a critical first step, as it allows trapped air to escape from the pleural cavity, rapidly relieving the pressure and allowing the lung to re-expand. After the immediate decompression is performed, the insertion of a chest tube is necessary for continuous drainage of air or fluid from the pleural space until the underlying issue is resolved, such as a lung injury or ongoing air leak.

This two-step process—first a needle decompression followed by the placement of a chest tube—addresses both the emergency of trapped air and the need for ongoing management of the pleural space, making it the most effective and comprehensive treatment approach for tension pneumothorax. Other options, such as chest tube insertion alone, intravenous fluids, or only oxygen administration, do not adequately address the immediate life-threatening nature of the condition and would likely lead to poorer outcomes.