You are treating a patient whose open chest wound has been sealed by EMTs on the scene before your arrival. During transport the patient becomes more dyspneic, tachycardic, and hypotensive. There are no breath sounds on the affected side, and the patient has JVD. Which of the following is the best action?
A) Reinforce the dressing with additional tape, using tincture of benzoin, if necessary, to improve the seal.
B) Perform a needle thoracostomy at the second intercostal space in the midclavicular line.
C) Perform a needle thoracostomy at the fourth intercostal space in the midaxillary line.
D) Remove the dressing and see if the patient's clinical status improves, then replace the dressing.
D
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