Potentially life-threatening emergency
Flail chest
Alerts and Notices
Synopsis
Flail chest is characterized by pleuritic chest pain, ecchymosis, and dyspnea. A more difficult to detect symptom is abnormal chest motion.
Commonly associated injuries include pneumothorax, hemothorax, and pulmonary contusion. Intraabdominal, upper extremity, and head injuries are also often seen due to the severe mechanism of injury needed to cause flail chest.
Management begins with oxygen administration, monitoring for signs of respiratory failure, noninvasive positive airway pressure administration by mask, and analgesia. More severe conditions may require endotracheal intubation and mechanical ventilation.
Codes
ICD10CM:S22.5XXA – Flail chest, initial encounter for closed fracture
S22.5XXB – Flail chest, initial encounter for open fracture
SNOMEDCT:
78011002 – Flail Chest
Look For
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Diagnostic Pearls
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Differential Diagnosis & Pitfalls
- Rib fracture(s)
- Pneumothorax
- Hemothorax
- Pulmonary contusion
- Pulmonary embolism
- Collapsed lung (see atelectasis)
Best Tests
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Management Pearls
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Therapy
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References
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Last Reviewed:04/23/2019
Last Updated:05/13/2019
Last Updated:05/13/2019