Flail chest with pulmonary contusion
- Three or more ribs fractured in at least two locations
- Paradoxical movement of “free-floating segment” may occasionally compromise ventilation.
- More importantly, an underlying pulmonary contusion may compromise oxygenation or ventilation
- Initial chest x-ray underestimates the degree of contusion
- The lesion evolve with time and fluid resuscitation
Management
- Respiratory failure may not be immediate
- Frequent re-evaluation is needed.
- Intubation(ETT) and mechanical ventilation is required
