 You are working in the emergency department. Your next patient is a 25-year-old male who complains of sudden onset right-sided chest pain and shortness of breath. He said that this pain started suddenly while he was sitting and he found it very difficult to breathe. He describes the pain as sharp and worse on inspiration. Besides shortness of breath, there are no other associated symptoms. He has no cardiac risk factors. And no risk factors for PE. He does not smoke or drink. On examination of this patient, he is a bit tachycardic. His blood pressure is normal. He is tachybnic and his oxygen is slightly low in room air. On examination of the chest, you notice decreased breath sounds on the right side. There are no wheezes and no crackles. The cardiac examination is normal. You ordered some oxygen for this patient. Ask the nurse to put in a peripheral IV line. Ask for a 12-leaf ECG and a chest x-ray. The EKG is normal. There is an abnormality on the chest x-ray. On the chest x-ray, while the left lung is normally aerated, you can see a partially collapsed right lung. You discuss it with the patient and discuss the procedures of putting in a chest tube. While you're out of the room to assemble the equipment, the nurses call for you to the bedside. The patient seems to be extremely short of breath. His blood pressure has dropped. His heart rate is high and it is impossible to take an oxygen saturation reading. When you examine the patient, you notice the trachea has deviated to the left. His JVP is elevated and there is further decreased breath sounds to the right side. You diagnose the patient as having a tension pneumothorax. You ask for a 16 gauge angiocatheter and insert it into the second intercostal space in the right mid-clavicular line. To perform your needle decompression, there's a gush of air as you insert the catheter. The patient's blood pressure increased. You then insert a chest tube in the fifth intercostal space in the anterior auxiliary line. After this, you discuss with your on-call thoracic surgeon about further management of this patient.