injuries poisoning
Flail Chest
Diagnosis of Flail Chest
Clinical evaluation Diagnosis of flail chest is clinical, ideally by observing the paradoxical motion of the flail segment during breathing. However, this motion may be difficult to see if inspiratory depth is limited by pain or obtundation due to other injuries. The paradoxical motion does not occur if the patient is mechanically ventilated, but the flail segment may be identified by its more extreme outward movement during lung inflation. Palpation can often detect crepitus of the flail segment and confirm abnormal chest wall motion. Chest x-ray can help confirm bone fractures and usually shows underlying pulmonary contusion; x-ray does not show cartilaginous disruption. 