You are transporting a patient who was involved in a high-speed motor vehicle collision. The patient is presenting with hypotension, distended neck veins, and decreased breath sounds on the left side. You suspect a thoracic great vessel injury. Which of the following actions is the most appropriate initial intervention?
Call for immediate surgical consult
Ensure airway management and perform chest decompression if needed
Administer high flow oxygen via non-rebreather mask
For patients presenting with signs suggestive of a great vessel injury, such as hypotension, neck vein distension, and decreased breath sounds, the correct initial intervention is to ensure airway management and breathing support, followed by decompression if tension pneumothorax is suspected. Rapid fluid resuscitation could worsen hemorrhage in these patients. Insertion of a chest tube might be necessary if there are clear indications of tension pneumothorax. High-flow oxygen is important but secondary to securing the airway and ensuring proper chest decompression when indicated. Immediate surgical consultation is crucial but should be preceded by stabilization of airway and breathing.
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