A 32-year-old male is transported via emergency medical helicopter after a high-speed motor vehicle collision. Upon assessment, he presents with decreased breath sounds on the left side, distended neck veins, and hypotension. Based on the mechanism of injury, what is the most likely diagnosis?
Tension pneumothorax
Hemothorax
Flail chest
Cardiac tamponade
The most likely diagnosis is a tension pneumothorax, which can occur due to significant blunt force trauma to the chest, such as that experienced in a high-speed motor vehicle collision. The clinical signs of decreased breath sounds on one side, distended neck veins, and hypotension are classic indicators of tension pneumothorax. Hemothorax and cardiac tamponade can present with some similar signs, but the decreased breath sounds are more indicative of pneumothorax.
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