Emergency Medical Technician (EMT) Basic Certification Practice Exam

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What happens in a tension pneumothorax?

Heart and blood vessels are compressed, affecting pump ability
Blood fills the lungs, reducing oxygen exchange
Ribs fracture and cause respiratory distress
Air is accumulated under the skin layers

The correct answer is: Heart and blood vessels are compressed, affecting pump ability

In a tension pneumothorax, air enters the pleural space and cannot escape, leading to increased pressure that compresses the lung on the affected side and can also push the mediastinum (the central compartment of the thoracic cavity) towards the opposite side. This compression affects the heart and great vessels, severely compromising their ability to fill and pump blood effectively. As pressure builds, it reduces venous return to the heart, which can lead to decreased cardiac output and ultimately result in shock. Recognizing this critical situation is vital for EMTs to provide prompt intervention, such as needle decompression, to relieve the pressure and restore normal physiology.