41. A 22-year-old man presents to the emergency department a…
41. A 22-year-old man presents to the emergency department after a motor vehicle collision as an unrestrained driver. He has suffered a penetrating trauma to his chest. He has muffled heart sounds, clear lung sounds bilaterally, and distended neck veins. Currently, his vital signs are BP 81/42 mm Hg, HR 123, RR 23, pulse oximetry 98%, and cardiac output 3 L/min. What is the best initial action?