What is the appropriate method to relieve a tension pneumothorax?

Needle decompression is the appropriate method to relieve a tension pneumothorax. This life-threatening condition occurs when air becomes trapped in the pleural space, leading to increased pressure on the lungs and mediastinum, which can severely compromise respiratory and cardiovascular function.

Needle decompression involves the insertion of a large-bore needle into the second intercostal space at the midclavicular line on the affected side. This allows the trapped air to escape, rapidly relieving the pressure and allowing for re-expansion of the lung. The speed of this intervention is critical, as a tension pneumothorax can rapidly become fatal if not addressed immediately.

While chest tube insertion is a definitive treatment for pneumothorax and is often performed following needle decompression, it is not the immediate lifesaving step in an acute tension pneumothorax scenario. Endotracheal intubation and manual ventilation may be necessary later for the management of the patient’s airway, but they do not address the underlying issue of the tension pneumothorax itself, which is the pressure from trapped air in the pleural cavity. Thus, needle decompression is the first-line intervention in this emergency situation.