What is the recommended treatment for a tension pneumothorax?

The recommended treatment for a tension pneumothorax is needle decompression followed by chest tube insertion. This approach is critical in managing the life-threatening accumulation of air in the pleural space, which leads to increased pressure that can collapse the lung and severely compromise respiratory function.

Needle decompression serves as an immediate, life-saving intervention to relieve the pressure. A large-bore needle is inserted into the second intercostal space in the midclavicular line on the affected side, allowing trapped air to escape and restoring normal pressure within the pleural cavity. This immediate relief is essential to restore respiratory mechanics and improve oxygenation.

Once the acute situation is addressed through needle decompression, the next step is to place a chest tube to facilitate continuous drainage of air (and possibly fluid) from the pleural space. This is vital to ensure that the pneumothorax does not recur and to promote lung re-expansion.

In contrast, options such as oxygen therapy alone or continuous positive airway pressure (CPAP) would not address the underlying problem of trapped air causing increased pleural pressure; they instead focus on improving ventilation, which doesn’t resolve the cause of tension pneumothorax. Immediate thoracotomy is typically reserved for more complex cases