Curriculum · Respiratory
Flail chest
What it is
A flail chest is fractures in 3 contiguous ribs at 2 sides. Those ribs stop moving with the rest of the chest and become a separate segment of their own.
It sits in the breathing part of the page, and the page puts it last of six: the priorities in assessing breathing, how to assess breathing, simple against tension pneumothorax, the management of a tension pneumothorax, the definition of a massive hemothorax, and then the definition of a flail chest. The order is the point of the page: the two that kill first, massive hemothorax and tension pneumothorax, are ruled out before the flail segment is named.
How it presents
When the chest expands on inspiration the segment comes in, and in expiration it comes out. That is paradoxical movement of the chest.
It is found by the three things the page asks about breathing: oxygen saturation; chest movement, which is normally bilateral and symmetrical; and auscultation of the chest for decreased air entry. The flail segment shows itself in the second of those: chest movement that is neither bilateral nor symmetrical.