#april2020mccqe1
A 49-year-old man with acute pancreatitis develops severe shortness of breath 15 minutes after undergoing placement of a catheter in his subclavian vein. His blood pressure is 100/60 mm Hg, pulse is 124/min, and respirations are 50/min. He is cyanotic and in obvious distress. His neck veins are distended, and his trachea deviates to the left. Breath sounds are diminished on the right side of his chest. Which of the following is the most appropriate next step in management?
(A) Chest x-ray
(B) Removal of the catheter
(C) Endotracheal intubation
(D) Needle thoracostomy in the second right intercostal space
(E) Tube thoracostomy in the left fifth intercostal space
A 49-year-old man with acute pancreatitis develops severe shortness of breath 15 minutes after undergoing placement of a catheter in his subclavian vein. His blood pressure is 100/60 mm Hg, pulse is 124/min, and respirations are 50/min. He is cyanotic and in obvious distress. His neck veins are distended, and his trachea deviates to the left. Breath sounds are diminished on the right side of his chest. Which of the following is the most appropriate next step in management?
(A) Chest x-ray
(B) Removal of the catheter
(C) Endotracheal intubation
(D) Needle thoracostomy in the second right intercostal space
(E) Tube thoracostomy in the left fifth intercostal space
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