Flail chest: Difference between revisions
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==Background== | ==Background== | ||
* | *Due to segmental fxs (in 2 or more locations on same rib) of 3 or more adjacent ribs | ||
*Commonly associated w/ respiratory failure | **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== | ==Diagnosis== | ||
*Paradoxical inward movement of involved portion during inspiration | |||
==Treatment== | ==Treatment== | ||
*Consider intubation even if pt's breathing initially seems adequate | *Pts w/ mild-moderate flail chest who are otherwise healthy may be managed w/o PPV | ||
*Analgesia | |||
*Consider intubation even if pt's breathing initially seems adequate, esp if: | |||
**Shock | |||
**Severe head injury | |||
**Comorbid pulmonary disease | |||
**Fx of 8 or more ribs | |||
**Age >65 | |||
*Surgical fixation is controversial | |||
==See Also== | ==See Also== | ||
Revision as of 03:08, 18 July 2011
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
Treatment
- Pts w/ mild-moderate flail chest who are otherwise healthy may be managed w/o PPV
- Analgesia
- Consider intubation even if pt's breathing initially seems adequate, esp if:
- Shock
- Severe head injury
- Comorbid pulmonary disease
- Fx of 8 or more ribs
- Age >65
- Surgical fixation is controversial