injuries poisoning
Flail Chest
Treatment of Flail Chest
Supportive care Sometimes mechanical ventilation Sometimes rib fracture repair Humidified oxygen is given to patients with flail chest. Analgesics may help improve ventilation by decreasing pain during breathing, but ventilation may need to be supported mechanically. Volume status should be closely monitored because harm can result from either hypovolemia (due to lung hypoperfusion) or hypervolemia (due to pulmonary edema). In select patients with flail chest (those who cannot be weaned from the ventilator, those with significant chest wall deformity, those who have impending respiratory failure despite pain control, or those who require thoracotomy for other reasons), operative fixation of ribs appears to reduce the risk of pneumonia, length of hospital stay, duration of mechanical ventilation, and death ( Treatment references ). 1.Simon B, Ebert J, Bokhari F, et al: Management of pulmonary contusion and flail chest: An Eastern Association for the Surgery of Trauma practice management guideline.J Trauma and Acute Care Surgery73(5 Suppl 4):S351-S361, 2012. doi: 10.1097/TA.0b013e31827019fd 2.Kasotakis G , Hasenboehler EA, Streib EW, et al: Operative fixation of rib fractures after blunt trauma: A practice management guideline from the Eastern Association for the Surgery of Trauma.J Trauma Acute Care Surg82(3), 618-626, 2017. doi: 10.1097/TA.0000000000001350 