Table of ContentsView AllTable of ContentsSymptomsCausesDiagnosisWhat to DoTreatment
Table of ContentsView All
View All
Table of Contents
Symptoms
Causes
Diagnosis
What to Do
Treatment
Flail chest occurs when at least three ribs are broken in two or more places. Instead of rigidly holding the normal shape of the chest, as the ribcage is meant to do, flail chest results in a segment of the chest wall flailing back and forth in the opposite direction of the rest of the chest wall.
This article looks at the symptoms and causes of flail chest. It also explains how the condition is diagnosed and treated.
What Is Paradoxical Breathing?
Signs and Symptoms of Flail Chest
Signs and symptoms of flail chest after a traumatic injury include:
Bruising, inflammation, and sensitivity in the injured area are also expected.
What Does a Flail Chest Sound Like?On physical examination, a person with a flail chest may present with decreased breath sounds and/orcrepitus(a grinding or crackling sound).
What Does a Flail Chest Sound Like?
On physical examination, a person with a flail chest may present with decreased breath sounds and/orcrepitus(a grinding or crackling sound).
Verywell / Gary Ferster
Causes of Flail Chest
Flail chest is typically a result of major blunt trauma to the chest wall. The most common causes of flail chest are direct blows to the chest, car accidents, and falls from high heights.
Rarely, flail chest is due to weak bones or bone disease.
How Flail Chest Is Diagnosed
Flail chest is typically diagnosed during an extensive physical evaluation after a traumatic injury. From there, one or more chestX-raysmay be done to fully examine the chest area. In addition to looking for broken ribs, other signs your provider may look for include punctured blood vessels or bruises on the lungs.
Medical professionals will monitor for changes in breathing that could be a sign of respiratory failure from flail chest.
Flail chest is a medical emergency. While this can be a life-threatening condition, there are ways to mitigate the damage if you believe someone has flail chest:
Stay Safe
If you are not the injured person, practiceuniversal precautionsand wearpersonal protective equipment, if available. Be sure that whatever caused the injury is no longer a threat to them—or you.
Call 911
If the911 operatorgives instructions, follow those instructions and ignore the remainder of the steps outlined here. If you cannot call 911, get the injured person to emergency medical help as soon as possible.
Stabilize the Flail Chest
Use a pillow to put pressure on the flail segment. Holding the flail segment in place keeps it from moving in the opposite direction of the surrounding muscle and bone. Stabilizing the area will reduce the chances of damage to the heart, lungs, and surrounding tissues.
If a pillow is not available, almost anything soft will do. Roll up a jacket or a blanket. If there is absolutely nothing available, have the patient lie on the affected side of the chest to discourage it from moving.
While you may be able to help stabilize a flail chest, it is critical that this injury receives emergency medical treatment. Even if the pain has subsided, failure to provide proper treatment for flail chest can lead topneumoniaand other life-threatening conditions, including a collapsed lung or blood around the heart.
Brace for the Pain
Regardless of how a flail chest is treated, it is going to hurt—probably worse than anything you or the injured individual has ever encountered. Over-the-counter pain medications aren’t going to do much for this level of pain, and stronger painkillers aren’t a good idea until emergency medical help is available to provide the full range of emergency treatment.
Try to remain as calm as possible and provide assurance that help is on the way.
Treatment for Flail Chest
Emergency medical treatment will first involve the delivery of oxygen, usually through a facemask. Intubation and mechanical ventilation will likely be used for those presenting with lung damage related to flail chest, as well as those who doctors worry will experience a chest cavity collapse.
Surgery may be required, but the decision for this will be based on an individual’s case and how stable they are.
Pain control is essential, which may involve an epidural and opioids, though the latter must be carefully prescribed due to the risk of inducing further respiratory concerns in some people.
Summary
Flail chest occurs when at least three ribs are broken in two or more places, causing a segment of the rib cage to become unattached from the chest wall. This condition is considered a medical emergency. Paradoxical movement, in which a segment of the ribs moves against the normal breathing pattern of the chest, is characteristic of flail chest. There will also be severe pain and possibly difficulty breathing.
If you or someone you are with may have flail chest, call 911 immediately. Depending on the the injured person’s condition, emergency surgery may be necessary.
9 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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University of Rochester Medical Center.Flail chest.
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