Will we see Tracheal Deviation with Tension Pneumothorax? Maybe...

Added: 2026-05-25

[00:00:00]If you're waiting for tracheal deviation to diagnose a tension pneumothorax, your patient might code in the meantime.

[00:00:05]Let's talk about this tracheal deviation being a hallmark sign of tension pneumothorax. I can tell you you don't see it that often. In fact, it's a really, really late sign, and if you're seeing tracheal deviation, you're in for a rough ride. The reason why it's such a late sign is because the pressure in your chest is so high that it's literally forcing your mediastinum over.

[00:00:26]That's causing that deviation to occur.

[00:00:28]I want you to remember that in tension pneumothorax, the killer is not your breathing being an issue with that collapsed lung. It's actually the obstructive shock with all that pressure that's in the chest causing all the vessels and everything in that area to kind of clamp down. A better way to think of tension pneumothorax is to look for the earlier signs of a tension pneumothorax. Think things like hemodynamic instability, absent breath sounds on one or even both sides, and worsening respiratory distress. Out of curiosity, have you ever actually seen tracheal deviation on a patient? Let me know down below.