Flail chest

Summary about Disease


Flail chest is a life-threatening chest wall injury that occurs when a segment of the rib cage breaks under blunt force trauma and becomes separated from the rest of the chest wall. This segment moves paradoxically with respiration, meaning it moves inward during inhalation and outward during exhalation, impairing lung function and causing significant pain.

Symptoms


Severe chest pain, especially with breathing

Shortness of breath or difficulty breathing

Paradoxical chest wall movement (the flail segment moves in the opposite direction of the rest of the chest)

Rapid, shallow breathing

Bruising or crepitus (a crackling sensation) over the injured area

Cough

Causes


Flail chest is almost always caused by significant blunt trauma to the chest, such as:

Motor vehicle accidents

Falls from height

Crush injuries

Severe blows to the chest

Medicine Used


Pain Management: Opioids (e.g., morphine, fentanyl), Non-steroidal anti-inflammatory drugs (NSAIDs)

Antibiotics: If pneumonia develops as a complication

Bronchodilators: If underlying lung disease contributes to respiratory distress.

Is Communicable


No, flail chest is not a communicable disease. It is a traumatic injury.

Precautions


Since flail chest is due to trauma, precautions focus on injury prevention:

Safe driving practices (avoiding distracted driving, following traffic laws)

Fall prevention measures (especially for elderly individuals)

Workplace safety measures in environments with heavy machinery or potential for falls

How long does an outbreak last?


Flail chest is not an outbreak-related condition. Recovery time varies depending on the severity of the injury, underlying health conditions, and effectiveness of treatment. It can range from weeks to months.

How is it diagnosed?


Physical Examination: Observation of paradoxical chest wall movement.

Chest X-ray: To identify rib fractures and lung contusions.

CT Scan: Provides a more detailed view of the chest, identifying the extent of fractures and any associated injuries.

Arterial Blood Gas (ABG): To assess oxygenation and ventilation.

Timeline of Symptoms


Immediately following injury: Severe pain, difficulty breathing.

Within hours: Paradoxical chest movement becomes more apparent.

Days to weeks: Bruising and swelling develop, risk of complications like pneumonia increases.

Weeks to months: Gradual improvement with treatment and healing.

Important Considerations


Flail chest is a medical emergency. Prompt diagnosis and treatment are crucial.

Associated injuries are common (e.g., pneumothorax, hemothorax, lung contusion, head injury, abdominal injury).

Respiratory support (e.g., intubation and mechanical ventilation) is often required.

Pain control is essential for improving breathing and preventing complications.

Surgical fixation of rib fractures may be considered in some cases.