Which finding is a late sign of tension pneumothorax?

• A. Tracheal deviation
• B. Respiratory distress
• C. Tachypnea
• D. Absent breath sounds

Answer: (A)

Tracheal deviation is a late sign because as air accumulates under pressure in a tension pneumothorax, the mediastinum shifts away from the affected side. That mediastinal shift pulls the trachea off the midline, signaling that intrathoracic pressure has become severely high and venous return to the heart is being compromised. Early indicators are things like respiratory distress and rapid breathing as the body tries to compensate, and diminished breath sounds on the affected side can occur, but they don’t necessarily indicate the severe progression that tracheal deviation does. When tracheal deviation appears, it points to a dangerous, advanced stage that requires immediate intervention.