Review Question - QID 216709

A 45-year-old man is brought to the emergency department after being struck by a car while crossing the street. In the emergency department, his temperature is 96.8°F (36°C), blood pressure is 103/68 mmHg, pulse is 115/min, respirations are 27/min, oxygen saturation is 86% on room air, and Glasgow coma score (GCS) is 8. He undergoes orotracheal intubation and subsequent chest radiograph shows fractures of right ribs 5-9 and bilateral pulmonary contusions. He is transferred to the intensive care unit. After a few hours on mechanical ventilation, the patient’s condition acutely deteriorates, and repeat vital signs show a blood pressure of 77/50 mmHg and pulse of 156/min. Physical exam shows distended neck veins, tracheal deviation to the left, and absent breath sounds on the right side. Which of the following is the most appropriate next step in management?