Flail chest: Difference between revisions
Neil.m.young (talk | contribs) (Text replacement - " w/ " to " with ") |
ClaireLewis (talk | contribs) |
||
| Line 11: | Line 11: | ||
==Management== | ==Management== | ||
* | *Otherwise healthy patients with mild-moderate flail chest may be managed without positive pressure ventilation | ||
*Analgesia | *Analgesia | ||
*Consider intubation even if patient's breathing initially seems adequate, | *Consider intubation even if patient's breathing initially seems adequate, especially if: | ||
**Shock | **Shock | ||
**Severe head injury | **Severe head injury | ||
Revision as of 22:38, 12 July 2016
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)
Diagnosis
- Paradoxical inward movement of involved portion during inspiration
Differential Diagnosis
Thoracic Trauma
- Airway/Pulmonary
- Cardiac/Vascular
- Musculoskeletal
- Other
Management
- 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