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Flail Chest

Welcome to this edition of the First Aid Show. Flail chest is a subject that has been added in the UK to First Aid at Work courses. And in this video, we look at flail chest and its treatment. When a segment of the thoracic cage is separated from the rest of the chest, a condition known as flail chest exists. Flail chest is usually defined when two fractures exist on a rib, which produces a free segment which cannot contribute towards lung expansion. As the ribs are damaged, it can cause breathing to stop and require forced ventilation. When the patient breathes in, the flail section will fall. When they breathe out, the flail section will be forced out. Where there is a flail chest, this is a very serious condition and it is likely to be additional damage to the chest and lungs. Other conditions such as collapsed lung, known as pneumothorax, could exist. This is where the lung cannot inflate, as there is damage and air has leaked into the chest cavity. In about one-third of cases where three or more ribs are fractured, a pneumothorax occurs. Common causes of flail chest are impact injuries, like those caused in car accidents by seat belts. You'll see bruising, grazes, and often the chest will not rise and fall in the normal manner, although this may not be visible until they are lying flat. If conscious, they will complain of pain when they breathe in and out, and when you touch their chest. They will also be breathing shallowly because this is less painful. Treatment is to try and sit them up, and they may hold their chest, which could help them. This will give them the best chance of healthy gas exchange. This may not be possible if the person has a spinal injury or they are in hypovolemic shock. Patients over 65 years old, fractures on both sides of the chest, or where three or more ribs have been fractured, this condition can be very serious. If available, oxygen should be given, to maintain their oxygen saturation levels. A patient with flail chest needs immediate medical attention. At ProTrainings Europe Ltd we offer over 350 video online training courses and classroom training at your workplace or at a local training centre nationwide. For more information see https://www.protrainings.uk or phone 01206 805359 or email [email protected] First Aid equipment is available from our store at https://www.first-aid-online.co.uk

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