Flail chest: Difference between revisions
Neil.m.young (talk | contribs) (Text replacement - "==Diagnosis==" to "==Evaluation==") |
Aganapathy (talk | contribs) |
||
| Line 11: | Line 11: | ||
==Management== | ==Management== | ||
*Admit | |||
*Otherwise healthy patients with mild-moderate flail chest may be managed without positive pressure ventilation | *Otherwise healthy patients with mild-moderate flail chest may be managed without positive pressure ventilation | ||
*Analgesia | *Analgesia | ||
Revision as of 10:09, 28 January 2018
Background
- Due to segmental fractures (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 with respiratory failure (due to pulmonary contusion)
Evaluation
- Paradoxical inward movement of involved portion during inspiration
Differential Diagnosis
Thoracic Trauma
- Airway/Pulmonary
- Cardiac/Vascular
- Musculoskeletal
- Other
Management
- Admit
- Otherwise healthy patients with mild-moderate flail chest may be managed without positive pressure ventilation
- Analgesia
- Consider intubation even if patient's breathing initially seems adequate, especially if:
- Shock
- Severe head injury
- Comorbid pulmonary disease
- Fracture of 8 or more ribs
- Age >65
- Surgical fixation is controversial