<prompt> A 24-year-old man is brought into the emergency depament after a fall from a ladder. His breathing is labored and he is cyanotic. No breath sounds can be heard, even in the right lung field, which is resonant to percussion. The first step in his management should beCricothyroidotomyObtaining a stat chest x-rayPassing an oral endotracheal tubeTube thoracostomy  <response>: This patient has a tension pneumothorax and immediate management by right tube thoracostomy is imperative. This diagnosis is a clinical one and treatment should not await x-ray confirmation. 