Approach to blunt chest injury Quiz: Ace Your Exams
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A 26-year-old man is brought to the trauma bay following a high-speed motor vehicle collision at 55 mph. Emergency medical services (EMS) report that the airbags deployed. There was not a prolonged extrication. The patient appears confused, but it is unclear if he struck his head. A cervical collar was placed in the field. Upon arrival at the hospital, the patient is confused but can speak a few words. Temperature 36 °C (98.6 °F), heart rate is 124/min, blood pressure is 88/50 mmHg, and respiratory rate is 24 with an SpO2 of 85% on nasal cannula. The patient is unresponsive. The primary survey demonstrates that the patient has tracheal deviation to the right side, absent breath sounds over the left chest, and ecchymoses overlying the left anterior chest wall without signs of a flail chest. Which of the following is the most appropriate next step in management?
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