A 45-year-old male involved in a motor vehicle accident presents with hypotension, distended neck veins, and decreased breath sounds on the right side. What is the most appropriate initial intervention?
Administer vasopressors
Perform needle decompression
Insert a chest tube
Administer fluid resuscitation
The patient shows signs of a tension pneumothorax, a common cause of obstructive shock in trauma patients, characterized by hypotension, distended neck veins, and diminished breath sounds. Immediate needle decompression helps relieve the pressure in the thoracic cavity, thereby improving venous return to the heart and stabilizing hemodynamics. While inserting a chest tube is definitive, the initial life-saving step is needle decompression. Fluid resuscitation and administration of vasopressors may help support the patient’s blood pressure but treating the underlying cause is paramount.
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