SIGNS AND SYMPTOMS OF TENSION PNEUMOTHORAX
Signs and symptoms of tension pneumothorax include the following:
b. Diminished or absent breath sounds.
c. Increasing difficulty in breathing (dyspnea) with cyanosis (bluish tint of lips,
inside of mouth, fingertips, and/or nail beds).
d. Rapid, shallow breathing (tachypnea).
e. Distended neck veins.
f. Abnormally low blood pressure (hypotension) evidenced by a loss of radial
g. Cool, clammy skin.
h. Decreased level of consciousness (AVPU scale).
j. Loss of consciousness.
k. Tracheal deviation (a shift of the windpipe to the right or left).
Tracheal deviation is a late sign of tension pneumothorax and will probably
not be observed.
The above signs and symptoms may be difficult to assess in a combat
situation. You must be alert to the possibility of tension pneumothorax
whenever a casualty has a penetrating chest wound. Therefore, the sole
criterion for treating a tension pneumothorax with needle decompression is a
penetrating chest wound with increasing respiratory difficulty.