NREMT Emergency Medical Technician (EMT) Cognitive ExamCardiology & ResuscitationHard
A 25-year-old male is experiencing a sudden onset of severe chest pain and difficulty breathing after being struck in the chest with a baseball. On assessment, you note absent breath sounds on the left side, tracheal deviation to the right, and distended neck veins. What is the MOST likely cause of his condition?
- ASpontaneous pneumothorax.
- BPulmonary embolism.
- CTension pneumothorax.
- DAcute myocardial infarction.
Show answer & explanationAnswer & explanation
Correct answer: C. Tension pneumothorax.
The patient's history of chest trauma, sudden chest pain and dyspnea, absent breath sounds on one side, tracheal deviation away from the affected side, and distended neck veins are classic signs of a tension pneumothorax, a life-threatening condition requiring immediate intervention.
Why the other options are wrong
- A. Spontaneous pneumothorax would cause absent breath sounds and chest pain/dyspnea, but typically not tracheal deviation or JVD unless it progresses to a tension pneumothorax.
- B. PE typically presents with sudden dyspnea and pleuritic chest pain, but not absent breath sounds, tracheal deviation, or JVD.
- D. AMI is unlikely in a 25-year-old with chest trauma, absent breath sounds, tracheal deviation, and JVD.
Tension Pneumothorax Recognition
Identification of a life-threatening condition where air enters the pleural space, cannot escape, and builds up pressure, collapsing the lung and shifting mediastinal structures.
- Unilateral absent or severely diminished breath sounds.
- Tracheal deviation away from the affected side.
- Jugular venous distention (JVD).
- Hypotension, tachycardia, severe dyspnea.
- Can be caused by trauma or spontaneously.
Memory trick: No breath, neck veins swell, trachea shifts, a tension spell!