A 62-year-old man is brought to the emergency department by paramedics after a head-on motor vehicle collision in which he was the restrained driver. He reports severe shortness of breath and sharp left-sided chest pain that worsens with breathing. He has no known allergies and takes no regular medications. On examination he is anxious and diaphoretic. Breath sounds are absent over the left hemithorax, the left chest is hyperresonant to percussion, the neck veins are distended, and the trachea is deviated to the right.
| Heart rate | 140/min |
| Respiratory rate | 30/min |
| Temperature | 36.5 °C |
| O2 saturation | 84%, room air |
| Blood pressure | 60/30 mm Hg |
Question 1 of 6
Which one of the following is the most appropriate immediate intervention?
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