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Flail chest - Coggle Diagram
Flail chest
CP
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- Severe chest pain: Flail chest can cause intense pain in the affected area due to the detachment of the ribs and the underlying lung tissue. The pain may be worsened during breathing or coughing.
- Difficulty breathing: Flail chest can lead to respiratory distress, making it difficult to breathe. Patients may experience shortness of breath, wheezing, or coughing.
- Rapid breathing: Flail chest can cause rapid breathing, known as tachypnea, as the affected area moves in and out during breathing.
- Low blood oxygen levels: Flail chest can impair gas exchange, leading to low blood oxygen levels (hypoxemia).
- Chest deformity: Flail chest can cause a visible deformity in the chest wall, as the affected area moves independently during breathing.
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- Paradoxical chest wall movement: Flail chest is characterized by paradoxical chest wall movement, where the affected area moves inward during inhalation and outward during exhalation, instead of expanding during inhalation and contracting during exhalation.
- Respiratory distress: Patients with flail chest may exhibit signs of respiratory distress, such as rapid breathing, wheezing, or coughing.
- Chest deformity: Flail chest can cause a visible deformity in the chest wall, as the affected area moves independently during breathing.
- Low blood oxygen levels: Flail chest can impair gas exchange, leading to low blood oxygen levels (hypoxemia).
- Chest tenderness: Flail chest can cause tenderness and sensitivity in the affected area due to the detachment of the ribs and the underlying lung tissue.
TTT
- Follow-up care: Regular follow-up care, such as chest X-rays and pulmonary function tests, may be necessary to monitor the patient's respiratory function and prevent further lung damage.
- The treatment for flail chest depends on the severity of the condition and the underlying cause. -
In most cases, the initial treatment involves supportive care, such as oxygen therapy, pain management, and close monitoring of respiratory function.
- The goal is to prevent further injury to the chest wall and to ensure that the patient is able to breathe adequately.
In addition to supportive care, there are several other treatments that may be used to manage flail chest:
- Chest physiotherapy: This involves techniques such as deep breathing exercises, coughing, and chest percussion and respiratory muscle training to help clear mucus from the lungs and improve lung function.
- Surgical intervention:
- In severe cases, surgical intervention may be necessary to stabilize the chest wall and prevent further injury or chest wall reconstruction.
- This may involve the insertion of chest tubes to drain excess fluid or the placement of metal plates or wires to hold the ribs in place.
- Medications:
- Antibiotics may be prescribed to prevent or treat any underlying infections
- Bronchodilators may be used to help open up the airways and improve breathing.
- Pain management, such as opioid analgesia, may be necessary to manage the pain associated with flail chest and improve respiratory function.
- Respiratory therapy: This may involve the use of mechanical ventilation to help the patient breathe, as well as the use of oxygen therapy to improve oxygen levels in the blood.
- Nutritional support: In cases where the patient is unable to eat due to respiratory distress, nutritional support may be necessary to prevent malnutrition and ensure that the patient has the energy needed to heal.
The recovery time for flail chest varies depending on the severity of the condition and the underlying cause. In most cases, it can take several weeks to several months for the chest wall to heal and for the patient to regain full lung function.
Inv.
- Chest X-ray: A chest X-ray is the initial investigation to confirm the presence of flail chest. It shows the displacement of the affected ribs and the underlying lung tissue, which may appear as a black triangle-shaped area known as the "flail segment."
- CT scan: A CT scan provides a more detailed image of the chest wall and the underlying lung tissue, which may help in identifying the extent of the injury and the presence of any underlying lung diseases.
- Pulmonary function tests: Pulmonary function tests, such as spirometry and lung volume measurements, can help assess the severity of respiratory impairment and the patient's response to treatment.
- Arterial blood gas analysis: Arterial blood gas analysis can help determine the patient's oxygenation status and the need for supplemental oxygen therapy.
- Echocardiography: Echocardiography may be performed to evaluate the patient's cardiac function, as flail chest can lead to cardiac complications such as heart failure.
- Bronchoscopy: Bronchoscopy may be performed to evaluate the airways for any underlying lung diseases, such as bronchiectasis or bronchitis, which may contribute to the flail chest.
- Sputum culture: Sputum culture may be performed to identify any bacterial or fungal infections that may be contributing to the flail chest.
- Pleural fluid analysis: Pleural fluid analysis may be performed to evaluate the presence of any pleural effusions or infections, which may be contributing to the flail chest.
Causes
Flail chest is typically caused by
- Trauma, such as a severe chest injury, that results in the fracture of multiple adjacent ribs.
- Other causes of flail chest may include underlying medical conditions, such as osteoporosis or infections that weaken the ribs, or conditions that cause muscle weakness, such as myasthenia gravis.
- In some cases, flail chest may also be a complication of surgery or other medical procedures that involve the chest.
- Flail chest, also known as floating rib syndrome, is a medical condition in which one or more ribs become detached from the surrounding muscles and bone, causing the chest wall to become unstable and move excessively during breathing.
- This can lead to difficulty breathing, pain, and increased risk of lung injury.