A young man presents to the emergency department with shortness of breath and chest pain. His HR is 120 , BP is 80/50, JVP elevated and trachea shifted to left. His oxygen saturation is 70% in spite of supplemental oxygen. What is the next step of management?
Insert a large bore needle on right side Insert a large bore needle on left side Arrange for an urgent chest xray and meanwhile give high doses of inhaled oxygen Emergency tracheostomy to secure airway