Author: Charlotte Elliott, Amelia Devine / Editor: Thomas MacMahon Reviewer: Charlotte Elliott, Amelia Devine / Codes: ResC8, ResP1, ResP2, SLO3, SLO6, TP3 / Published: 11/05/2022

A 27-year-old male has self-presented to your Emergency Department (ED) with acute onset of shortness of breath and severe pain to the right side of his chest.

He is usually fit and well, does not take any regular medication and is a non-smoker. From the end of the bed he looks sweaty, in obvious pain and is tachypnoeic. He is taken straight to resus.

On assessment, his airway is patent, but he is struggling to finish a sentence. His sats are 92% on room air, rising to 100% on a 15L non-rebreather oxygen mask. His respiratory rate is 30.

His blood pressure is 100 systolic, heart rate is 120 and looks sinus on the monitor. He is apyrexic.

On observation the right side of his chest does not rise as much as the left side. There are no breath sounds on the right side of the chest, which is hyperresonant to percussion.

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