In any patient presenting with chest trauma, airway, breathing, and circulation should be assessed. Penetrating chest wounds must be covered with an airtight occlusive bandage and a clean plastic sheeting. Administration of 100% supplemental oxygen can help reduce the size of the pneumothorax by decreasing the alveolar nitrogen partial pressure. This creates a diffusion gradient for nitrogen, thus accelerating the resolution of the pneumothorax. Without oxygen, only 1.25% of the air is absorbed in 24 hours. Positive pressure ventilation should be avoided initially, as it will contribute to increasing the size of the tension pneumothorax. Patients can be placed on positive pressure ventilation after a chest tube is placed
