(2 of 3)An adult has an open pneumothorax from penetrating c…

(2 of 3)An adult has an open pneumothorax from penetrating chest trauma. The pt. is conscious with labored breathing. Breath sounds are unilateral. Skin is cool and moist with cyanosis of the lips and nailbeds. The patient momentarily improved after the previous intervention, but is now rapidly declining. The pt. remains conscious and in severe respiratory distress; neck veins are distended and the BP has dropped to 60/40. What action is indicated next?