What is the recommended management for a patient presenting with a tension pneumothorax?

The recommended management for a patient presenting with a tension pneumothorax is needle decompression followed by tube thoracostomy. Tension pneumothorax occurs when air accumulates in the pleural space and creates increasing pressure, leading to respiratory distress, decreased venous return, and potential cardiovascular collapse.

Needle decompression is the immediate lifesaving intervention performed to quickly relieve the pressure in the pleural space. This is typically done by inserting a large-bore needle into the second intercostal space at the midclavicular line on the affected side. It allows trapped air to escape, alleviating the pressure and restoring normal physiological function temporarily.

Following needle decompression, tube thoracostomy is indicated to provide continuous drainage of air or fluid in the pleural space. This procedure helps to ensure that the air does not reaccumulate and addresses the underlying cause of the pneumothorax. This two-step approach is critical for effectively managing tension pneumothorax and preventing further complications.

Other management options like chest x-ray followed by observation would delay necessary intervention, immediate intubation may not address the underlying issue of the pneumothorax, and administration of bronchodilators is not appropriate as these do not resolve