What is the first intervention when pneumothorax is suspected?

• A. Assess breath sounds and respiratory effort
• B. Obtain chest X-ray
• C. Administer diuretics
• D. Start antibiotics

Answer: (A)

When pneumothorax is suspected, the priority is to quickly assess the patient's breathing status. Listening to breath sounds and judging respiratory effort at the bedside provides immediate clues about ventilation and the severity of the problem. Diminished or absent breath sounds on one side suggests a collapse or air in the pleural space, while increased work of breathing or tachypnea signals respiratory distress that may require oxygen and close monitoring. This rapid bedside assessment guides urgent decisions and actions, including whether to escalate to needle decompression in a suspected tension pneumothorax. Imaging like a chest X-ray is important for confirmation but takes time and should not delay initial assessment and stabilization. Diuretics and antibiotics are not indicated for a suspected pneumothorax.