A patient came with chest trauma and tachypnea (RR >40) and after check-up he had hypertension (BP = 90/60) and hyper resonant note on the involved side. What will be the next step?

Ans. D. Wide bore needle insertion on 2nd ICSThis is a case tension pneumothorax.* It is a case of typical tension pneumothorax.* Management: Immediately place a large-bore needle (preferably 14G/12G) or IV catheter into the pleural space at the second ICS on the involved side. Then place a chest tube.* Now the guideline has changed from second ICS to fifth ICS. But it does not mean that it should not be done in second ICS. Best is 5th ICS > 2nd ICS.