A 33-year-old woman is involved in a high-speed automobile collision. She arrives at the emergency department gasping for breath. Her lips are cyanotic and she has flaring nostrils. There are bruises over both sides of the chest, and tenderness suggestive of multiple rib fractures. Her blood pressure is 60/45mmHg, pulse is 160/min andfeeble,and central venous pressure is 25 cm H2O. Her neck and forehead veins are distended.She is diaphoretic and has a hint of subcutaneous emphyse main the lower neck and upper chest. Her left hemithorax has no breath sounds and is hyperresonant to percussion. The trachea is deviated to the right,as are the heart sounds. Which of the following is the most likely diagnosis?
A. Air embolism from tracheobronchial injuries
B. Flail chest due to multiple rib fractures
C. Massive intrapleural bleeding from torn intercostal vessels
D. Massive mediastinal bleeding from ruptured aorta
E. Tension pneumothorax caused by lung punctured by broken ribs
A. Air embolism from tracheobronchial injuries
B. Flail chest due to multiple rib fractures
C. Massive intrapleural bleeding from torn intercostal vessels
D. Massive mediastinal bleeding from ruptured aorta
E. Tension pneumothorax caused by lung punctured by broken ribs