What surgical procedure is typically performed for the management of tension pneumothorax?

Needle decompression is the appropriate surgical procedure for the immediate management of tension pneumothorax. This condition occurs when air enters the pleural space and cannot escape, leading to increased pressure that compromises cardiovascular and respiratory function. The priority in a tension pneumothorax is to quickly relieve this pressure to prevent mediastinal shift and cardiovascular collapse.

Needle decompression involves the insertion of a large-bore needle or cannula into the second intercostal space in the midclavicular line, usually on the affected side. This allows trapped air to escape from the pleural cavity, rapidly alleviating the life-threatening effects of the tension pneumothorax. It is a quick and vital intervention that can be performed in emergency settings, even before further definitive treatments, such as chest tube insertion, are conducted.

While chest tube insertion is a critical next step following initial decompression to allow ongoing drainage of air or fluid and to facilitate re-expansion of the lung, it is not the immediate intervention for acute tension pneumothorax. Thoracotomy is a more invasive procedure typically reserved for situations where there is significant underlying thoracic injury or other complicated pathologies. Open thoracostomy, an older and less common approach, is rarely