Emergency patient management

Triage Care scenarios involving car accidentA patient in car accident today brought in by Ambulance personnel to the emergency room where you work as care provider. Senario This is 30 African American male who is normally healthy. He has presented to Emergency Room in a motor vehicle accident. This patient is currently having trouble breathing and very upset and apprehensive. Rescue Personnel tell you that his breath sounds absent in on the right side and chest expansion is unequal and trachea shifted to the left upon x-ray. There is large contusion to the right rib cage. Patient has no known allergies, he is normally healthy, no previously illness. His family history is benign. No family history of any illness. He does not drink alcohol, does not smoke or uses drugs. He is not on any medication. He works at auto mechanic at local mechanic shop. He eats very healthy. he eats fruits and vegetables and drinks 8 glasses of water a day. He walks normally most day of the week for 30 minutes . He likes to swim and he likes to golf and also he has no other illnesses. Vital signs Temperature 97.2 Heart rate: 110 bpm Blood pressure 140/92 Respiratory rate: 28 Oxygen saturation 88% at room air. CT of the head done and it is normal X-ray of extremities: No fracture Internal bleeding has been ruled out This patient does not have headache, no eye complaint, no blurry vision, no eye pain or drainage, no ear pain or drainage, no nasal pain or drainage, no sore throat, no difficulty of swallowing, no swollen glands, no known respiratory problem in the past, no heart problem in the past, no history of heart condition, no nausea, no vomiting, no diarrhea. He has normal stool daily. Voids 4 to 5 times a day, clear amber urine. No blood observable blood in the urine. No muscle weakness, no prior muscle weakness He has no prior muscle weakness, no prior neurological disorder, no prior tingling sensations on extremities, no prior numbness. No specificity Psych history: Benign, no mood disorder, no problem with anxiety, no depression, no feeling of hopelessness. He is active and engage in social activities on the normal basis. Assessment He is alert and apprehensive, his oxygen saturation 88% at room air. He appears cool, diaphoretic. He has blue discoloration to his right anterior thorax. He has normal cephalic. PERRLA. Sclera is clear. He has pink nasal mucosa. His oral mucosa is pink and moist without blood or drainage. Neck x-ray done. Trachea deviation to the left. He has neck pain and never pinch upon exam. He is tachycardia without any murmur. He is tachypneic. His breath sounds absent on right upper lob right lower lob with unequal chest expansion. He has decreased tactile fremitus hyperresonance on right upper lob and right lower lob. His abdomen soft and none tender positive bowl sounds. Moves all extremities without limitations and good range of motion. His strength 5 and 5 on upper and lower extremities. His is DTR 2+. How do you treat the above patient who was presented to emergency room where you work as provider?