What is the primary treatment for tension pneumothorax?

The primary treatment for tension pneumothorax is needle decompression followed by chest tube insertion. Tension pneumothorax occurs when air becomes trapped in the pleural space, leading to increased pressure that impairs respiratory function and can compromise cardiovascular stability.

Needle decompression is a critical first step, typically performed in the second intercostal space at the midclavicular line, which allows trapped air to escape, relieving pressure and restoring normal function to the lungs and heart. Following this initial intervention, chest tube insertion is necessary to provide ongoing drainage of air (or fluid, if present), thereby preventing recurrence of the pneumothorax and ensuring proper lung expansion.

While immediate surgical intervention may be required in some severe cases, it is not the primary treatment for tension pneumothorax in an emergency setting. High-flow oxygen therapy, while beneficial in managing hypoxia, does not address the underlying cause of the tension pneumothorax. Fluid resuscitation is primarily related to managing shock or fluid loss and does not treat the critical condition of tension pneumothorax itself. Hence, the combination of needle decompression followed by chest tube insertion remains the most effective and immediate treatment approach for this life-threatening condition.