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Flail chest with respiratory failure — DipIMC MCQ

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HardTraumaFlail chest with respiratory failureDipIMC

A 58-year-old driver is trapped after a side-impact crash. He has paradoxical movement of the left chest, SpO2 86% despite oxygen, respiratory rate 38/min, systolic blood pressure 112 mmHg and increasing exhaustion during extrication. What is the most appropriate immediate action?

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Correct answer: C — Support ventilation and expedite extrication to a major trauma centre

Flail chest with hypoxaemia and fatigue indicates evolving ventilatory failure requiring oxygenation, analgesia and possible ventilatory support. Chest strapping impairs ventilation and is obsolete. The destination should reflect major thoracic trauma, not proximity alone.

Reference: NICE NG39 Major trauma; ATACC