Emergency if: MOI consistent with serious trauma to thorax and: Shortness of breath or difficulty breathing, Anxiety, fear, confusion, or restlessness, Distended neck veins, Bulging or bloodshot eyes, Suspected rib(yellow flag) or sternal fx, Severe chest pain aggravated by deep inspiration, Abnormal chest movement on one side, Coughing up blood, Abnormal or absent breath sounds, Rapid, weak pulse, Low blood pressure, Cyanosis