23rd September 2020

A 24-year-old man is brought to A+E after involvement in a high-speed road traffic accident

A 24-year-old man is brought to A+E after involvement in a high-speed road traffic accident. The patient has a GCS of 6 and is otherwise haemodynamically stable, so is intubated and ventilated before continuing with the rest of the primary survey. Later the patient becomes tachycardic, tachypnoeic with falling oxygen saturations, and hypotensive. On examination there is slight tracheal deviation to the left, with reduced breath sounds on the right chest. What is the most likely reason for the patient’s decline?

Select the SINGLE most appropriate option from the list below. Select ONE option only.