You have arrived on the scene of a paramedic who was shot as…
You have arrived on the scene of a paramedic who was shot as they approached a residence on a call. The scene has since been secured. Your patient is a 38-year-old with one gunshot wound to the left side of the chest at the fifth intercostal space in the midaxillary line. They are pale, cool, and awake but agitated. The patient is diaphoretic and complaining of pain in their side and difficulty breathing. The patient’s EMT partner has applied oxygen by nonrebreathing mask and placed an occlusive dressing over the entry wound before your arrival. As you continue your assessment, the patient’s level of consciousness decreases. They respond to verbal stimuli. Their airway is clear, respiratory rate is 38 per minute and shallow, neck veins are flat, and breath sounds are absent on the left side. The patient lacks a radial pulse, and the abdomen is non-guarded and non-tender. Which of the following should you do first?
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