ABSTRACT
A 30-year-old man is brought into the emergency department following a fight in which he was stabbed in the right side of his chest. He appears distressed and is very short of breath. On examination, he has a heart rate of 130 bpm, blood pressure is 80/60 mmHg, saturations are 95% on 15 L/min of oxygen with a respiratory rate of 30, and he has a raised JVP and prominent neck veins. His trachea is deviated to the left. On percussion, the right side of his chest is hyper-resonant, with no breath sounds on auscultation. The most appropriate course of action would be:
Chest X-ray
Arterial blood gas
Insertion of a large-bore cannula in the right side of the chest
Insertion of a large-bore cannula in the right/left arm
Examination of the abdomen
