In traumatic arrest management, which action is advised if tension pneumothorax is suspected?

• A. Provide bilateral needle decompression
• B. Defibrillate immediately
• C. Administer IV antibiotics
• D. Stop resuscitation and transport

Answer: (A)

In traumatic arrest, a tension pneumothorax creates an obstructive problem that rapidly collapses venous return and compromises cardiac filling. The fastest, most effective fix is to relieve the pressure right away. Bilateral needle decompression aims to release air from both sides, increasing the chance that at least one side is relieved and, in many trauma scenarios, addressing possible bilateral involvement. This immediate intervention can restore venous return and improve CPR effectiveness, buying time for definitive care.

Defibrillation targets a rhythm problem, not the mechanical cause of collapse in this situation, so it doesn’t address the underlying issue. Antibiotics aren’t useful in the acute resuscitation phase, and stopping resuscitation isn’t appropriate while a reversible cause may be treated.