Trauma Scene Size-Up and Survey Practice Test

You are transporting a patient with a stab wound to the right chest. Initially, his breath sounds were equal bilaterally, and his SpO2 was 98% on a non-rebreather mask. Ten minutes into transport, he becomes increasingly agitated and tachypneic. His SpO2 drops to 90%, and you now note absent breath sounds on the right side and JVD.

You are the first on scene at an MVC with an entrapped driver. You have access to the patient's upper body. He is pale and diaphoretic, with a respiratory rate of 28 and shallow. His airway is patent. You note absent breath sounds on the right, a weak carotid pulse of 140, and his trachea appears to be shifted to the left.