management of a tension pneumothorax

Last reviewed 08/2021

A tension pneumothorax is a medical emergency requiring immediate decompression:

  • insert a large-bore intravenous cannula into the second intercostal space in the midclavicular line on the affected side

  • if there is a sudden release of air, the diagnosis is confirmed and should be followed immediately by an intercostal chest drain in the fifth intercostal space in the midaxillary line

  • if the diagnosis is in doubt, order a chest x-ray and proceed with the chest drain if confirmatory