What is the recommended approach for managing a suspected tension pneumothorax in the field?

In the management of a suspected tension pneumothorax, the recommended approach is to perform a needle decompression followed by chest tube insertion. This is critical because tension pneumothorax is a life-threatening condition that occurs when air enters the pleural space and cannot escape, leading to increased pressure that compromises respiratory and cardiovascular function.

Performing a needle decompression allows for the rapid release of this trapped air, which can alleviate the pressure on the lungs and mediastinum, restoring normal physiology. This procedure is typically conducted using a large-bore needle inserted at the second intercostal space in the midclavicular line on the affected side, effectively creating a vent to relieve the pressure.

Following the needle decompression, chest tube insertion is recommended for ongoing management, as it can provide continuous drainage of air (or fluid) from the pleural space, preventing recurrence of the tension pneumothorax. This two-step intervention is essential to stabilize the patient before transporting them to a medical facility for further treatment.

The other options do not adequately address the urgent nature of this condition. Administering high-flow oxygen and monitoring may help improve oxygenation but does not relieve the underlying issue of pressure. Initiating CPR is inappropriate unless the patient