Which finding would strongly suggest pneumothorax in a trauma victim?

The presence of absent breath sounds is a significant clinical finding that strongly suggests pneumothorax, particularly in the context of a trauma victim. In a pneumothorax, air enters the pleural space, which can cause the affected lung to collapse partially or completely. As a result, the normal lung sounds, which are produced by air movement in the lungs, may be drastically reduced or eliminated entirely upon auscultation of the chest.

When there is no breath sound on one side of the chest, it indicates that either the lung is not functioning properly (due to collapse) or that there is an obstruction in the airway that prevents air from reaching the lung. In cases of trauma, a pneumothorax can develop rapidly, and the absence of breath sounds is a critical indicator that requires immediate medical attention.

On the other hand, pronounced crackles and inspiratory wheezing are associated with other pulmonary conditions such as fluid in the airways or bronchospasm, which are not specific to pneumothorax. Dullness on percussion typically indicates fluid accumulation in the pleural space, such as in pleural effusion, rather than the air accumulation seen in pneumothorax.