MSFinals-5754

A 21-year old patient is brought to the Emergency Department by paramedics following an assault. On examination, there are two puncture wounds on the posterior chest wall. The ambulance crew believe the patient was attacked with a screwdriver. He is currently extremely short of breath, haemodynamically unstable, and his oxygen saturations are falling despite high-flow oxygen. There are reduced breath sounds in the right hemithorax.
What is the most appropriate first step in managing this patient?