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This is a classic tension pneumothorax: hypotension + respiratory distress + tracheal deviation + absent breath sounds. Tension physiology requires immediate decompression with a large-bore needle (14g, 4.5cm) at the 2nd ICS MCL. Chest tube is definitive but takes too long. Intubation without decompression will kill the patient (positive pressure worsens tension).

A 45-year-old male with a stab wound to the left chest develops severe respiratory distress, hypotension, and absent breath sounds on the left side. The trachea is deviated to the right. Your next step is: atls past questions

A) Insert a chest tube B) Perform a thoracotomy C) Administer oxygen therapy D) Perform a needle decompression This is a classic tension pneumothorax: hypotension +

Remember the golden rule of ATLS: Every past question will circle back to this principle. Download a question bank, time yourself, and review every rationale—especially the ones you get wrong. Do that, and you will not only pass the ATLS exam but also become a more competent, confident trauma provider. Your next step is: A) Insert a chest