He follows commands. Pupils equal and reactive to light at 3mm. Skin cool and clammy. Neck veins are distended with the head of the bed elevated 45 degrees. Respirations are labored, rapid, and shallow.
Lung sounds are clear on the right, hyperresonant on the left.
His trachea shifted to the right of midline. Heart tones are muffled. When you percuss his chest, you hear sounds characteristic of hypertympany. Labs You haven't obtained any labs since admission at which time his myocardial enzymes were elevated.