What is the recommended action if a tension pneumothorax is suspected during pediatric arrest?

• A. Immediate needle decompression or chest tube placement per protocol.
• B. Antibiotics.
• C. Observe and reassess.
• D. Position and wait.

Answer: (A)

In pediatric arrest, a suspected tension pneumothorax is a life-threatening situation because air trapped under pressure compresses the lung and shifts the mediastinum, drastically reducing venous return to the heart. The remedy is rapid relief of that pressure, achieved by immediate needle decompression or chest tube placement per your protocol. This quickly allows the lung to re-expand, restores ventilation and circulation, and makes CPR more effective. Other options, like antibiotics, watching and waiting, or delaying intervention, do not address the mechanical problem and can be fatal. After decompression, continue resuscitation per protocol and obtain definitive chest tube management as soon as possible.