Rev Up Your EMS Skills 2026 – Master the Protocol with This Dynamic Practice Test!

The key idea is that needle decompression is guided by clinical signs of tension pneumothorax and patient instability, not by meeting two exact numerical thresholds. A patient with absent or diminished lung sounds and suspected tension pneumothorax should be decompressed promptly if there is signs of instability, such as low blood pressure or low oxygen saturation. It’s not necessary for both SBP to be below 90 and SpO2 to be below 94% at the same time; either finding can indicate significant physiologic compromise that warrants immediate treatment. Delaying decompression to wait for both criteria could worsen outcomes, since the pressure buildup behind a tension pneumothorax can rapidly impair ventilation and circulation.