What is the initial treatment for tension pneumothorax?

• A. Emergency large bore needle decompression
• B. Chest tube
• C. Supplemental oxygen therapy
• D. Observation and monitoring only

Answer: (A)

Tension pneumothorax is an emergency where air accumulates under pressure in the pleural space, rapidly collapsing the lung and squeezing the heart and great vessels. The priority is to relieve that pressure immediately to restore ventilation and venous return.

The best initial action is emergency large-bore needle decompression. This rapidly vents the trapped air and decompresses the pleural space, helping to stabilize breathing and circulation right away. After this immediate decompression, chest tube placement is performed for definitive management to re-expand the lung and prevent reaccumulation. Supplemental oxygen is important but does not quickly relieve the life-threatening pressure. Observation or monitoring alone would miss the needing urgent intervention.