Tension Pneumothorax

Clinical features

This is a clinican diagnosis

  • History of penetrating trauma, positive pressure ventilation or airways disease
  • Air hunger
  • Hypotension
  • ± distended neck veins
  • ± hyperresonant on tension pneumothorax side


Do NOT x-ray - this is a clinical diagnosis

  • Immediate needle decompression.
  • Confirm side clinically.
  • Inform patient.
  • 14G cannula .
  • 2nd intercostal space.
  • Listen for hiss.
  • Protect with gauze.
  • Tape and leave in situ.
  • Prepare chest drain for insertion.

Vimeo is of chest decompression.

Content by Dr Íomhar O' Sullivan 04/01/2007. Last review Dr ÍOS 15/09/13.