What is the emergency treatment for tension pneumothorax?

In the case of a tension pneumothorax, the most effective emergency treatment involves immediate needle decompression followed by the insertion of a chest tube. Tension pneumothorax occurs when air becomes trapped in the pleural space, leading to increased pressure that can collapse the lung and compress vital structures, such as the heart and great vessels.

Needle decompression is performed as a rapid first response to relieve the pressure in the pleural cavity. This procedure typically involves inserting a large bore needle into the second intercostal space in the midclavicular line to allow trapped air to escape and the thoracic pressure to normalize. Following this initial intervention, a chest tube is then placed to facilitate ongoing drainage of air (or fluid, if present) from the pleural space, allowing the lung to re-expand fully and restoring normal respiratory function.

Other methods, such as intubation and ventilation, may be necessary later for respiratory support, especially if the patient is unable to maintain adequate ventilation due to the pneumothorax. However, they do not address the critical situation of the tension pneumothorax itself. Surgical intervention is usually reserved for more complex cases or when other methods fail, while administering IV fluids is not a primary treatment