Answer:
Under the BLS-PCS Blunt/Penetrating Injury Standard, “Chest Injury” reads subsection 5. “for patients who have suspected pneumothorax and require ventilations, ventilate with a lower tidal volume and rate of delivery to prevent exacerbation of increasing intrathoracic pressure”.
To clarify, this applies to all pneumothoraces, not just tension pneumothoraces.
You are correct in your interpretation: lower tidal volume means giving smaller volumes of ventilation (smaller squeeze) while lower rate of delivery means a lower rate of breaths.
It should be mentioned that if the patient is suspected to have a tension pneumothorax, this should be recognized as a pre-terminal condition. You should prepare for impending cardiac arrest and provide expedited transport. Transportation should not be delayed to wait for the arrival of any potential ACP crew back-up.