You arrive at the scene of a major motor vehicle crash. the patient, a 50-year-old female, was removed from her vehicle prior to your arrival. bystanders who removed her state that she was not wearing a seatbelt. the patient is unconscious, tachycardic, and diaphoretic. your assessment reveals bilaterally clear and equal breath sounds, a midline trachea, and collapsed jugular veins. you should be most suspicious that this patient has experienced a:
