Final answer:
The patient's symptoms suggest a tension pneumothorax, which is a medical emergency requiring immediate needle decompression and chest tube placement to relieve the trapped air and allow lung re-expansion.
Step-by-step explanation:
The presentation of a 24-year-old patient after a motor vehicle accident (MVA) with absent breath sounds in the right chest, low blood pressure (BP), and distended neck veins is suggestive of a tension pneumothorax. This is a medical emergency caused by air trapping in the pleural space, which increases intrathoracic pressure, leading to compression of the lung and cardiovascular structures, impaired venous return, and ultimately, shock.
Treatment involves immediate decompression of the pleural space. This can be done with the swift insertion of a large bore needle into the second intercostal space at the midclavicular line followed by chest tube placement to allow trapped air to escape and the lung to re-expand. Blood pressure and oxygenation typically improve after decompression. Definitive care may include a chest tube placement with ongoing monitoring and supportive care.