In assessing for a tension pneumothorax, what should be looked for besides rapid breathing?

In assessing for a tension pneumothorax, tracheal deviation is a critical clinical sign to observe. When a tension pneumothorax occurs, air accumulates in the pleural space, creating increased pressure that can push the mediastinum away from the affected side. This pressure can cause the trachea to shift towards the contralateral side (the side opposite to the pneumothorax). Noticing this deviation is important because it indicates a significant change in the thoracic cavity's pressure dynamics, which is characteristic of a tension pneumothorax and requires immediate medical intervention.

Recognizing tracheal deviation helps in formulating a diagnosis quicker and can guide treatment decisions, such as performing needle decompression or chest tube placement to relieve the pressure. This specific sign differentiates tension pneumothorax from other thoracic injuries that may not exhibit the same level of mediastinal shift.