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Flail chest — DipIMC MCQ

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HardTraumaFlail chestDipIMC

A cyclist has a flail segment, severe chest pain, SpO2 88% and increasing work of breathing after blunt trauma. What is the immediate management priority?

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Correct answer: C — Support oxygenation, give titrated analgesia and reassess ventilation

The best answer is “Support oxygenation, give titrated analgesia and reassess ventilation”. A flail segment indicates significant chest-wall injury and frequently underlying pulmonary contusion. Correct hypoxaemia, provide carefully titrated analgesia to improve ventilation, monitor for fatigue or pneumothorax and escalate respiratory support and trauma-centre care as required. Circumferential binding restricts ventilation, and excessive crystalloid may worsen lung injury. Airway and breathing treatment precedes a detailed secondary survey.

Reference: NICE NG39, Major trauma: https://www.nice.org.uk/guidance/ng39/chapter/recommendations