Flail Chest

Question 1

What is flail chest?

Answer 1

When a segment of the chest does not have bony contiguity with rest of thoracic cage

Question 2

What is the most common cause of flail chest?

Answer 2

Blunt force trauma
- Motor Vehicle Collision
- Fall from a height

Question 3

What is a major problem to consider with flail chest?

Answer 3

Respiratory failure due to underlying pulmonary injury

Question 4

Major sx of flail chest

Answer 4

• Pain
• Respiratory distress

Question 5

What will be present when palpating a patient with flail chest

Answer 5

Crepitus

Question 6

What may not be seen in a conscious patient with flail chest due to splinting of the chest wall?

Answer 6

Paradoxical chest wall movement

Question 7

First line treatment of Flail Chest

Answer 7

O2, 2-15L/min based on O2 saturation

Question 8

What medications should be used for pain control?

Answer 8

• Fentanyl 50-100mcg IV/IM q1-2hrs prn
• Morphine

Question 9

What percentage of patients with flail chest will need to be immediately intubated

Answer 9

50%

Question 10

Do we still use chest wall supports (sandbags/taping)

Answer 10

Not indicated, may reduce pain but will reduce vital capacity