Flail chest: Difference between revisions

(Text replacement - "pt's" to "patient's")
(Text replacement - "Fx" to "Fracture")
Line 17: Line 17:
**Severe head injury
**Severe head injury
**Comorbid pulmonary disease
**Comorbid pulmonary disease
**Fx of 8 or more ribs
**Fracture of 8 or more ribs
**Age >65
**Age >65
*Surgical fixation is controversial
*Surgical fixation is controversial

Revision as of 04:43, 3 July 2016

Background

  • Due to segmental fxs (in 2 or more locations on same rib) of 3 or more adjacent ribs
    • Leads to free-floating segment of ribs that no longer attach to rest of thorax
  • Commonly associated w/ respiratory failure (due to pulmonary contusion)

Diagnosis

  • Paradoxical inward movement of involved portion during inspiration

Differential Diagnosis

Thoracic Trauma

Treatment

  • Pts w/ mild-moderate flail chest who are otherwise healthy may be managed w/o PPV
  • Analgesia
  • Consider intubation even if patient's breathing initially seems adequate, esp if:
    • Shock
    • Severe head injury
    • Comorbid pulmonary disease
    • Fracture of 8 or more ribs
    • Age >65
  • Surgical fixation is controversial

See Also