Assessment findings for a patient who was thrown from a motorcycle indicate that he has a flail chest wall segment to his right anterior chest. He exhibits labored breathing and an SpO2 of 92%. Breath sounds are clear and equal bilaterally. The segment has been stabilized, and you are prepared to start positive pressure ventilation. Given these assessment findings, which type of injury underlying the flail segment is your primary concern?

Emergency medical technicians (EMTs) should rapidly recognize and treat chest trauma, which can be fatal if patients are not stabilized before transport. Chest trauma can be categorized into two areas: Injuries that cause significant blood loss and Injuries that compromise ventilation.  Primary assessment treatments include: Manual stabilization of the cervical spine Establishing and maintaining a patent airway Determining the patient's level of consciousness using the AVPU scale    Chest injuries can be caused by: Penetrating trauma, such as gunshots, lacerations, and punctures Blunt... Show more

Emergency medical technicians (EMTs) should rapidly recognize and treat chest trauma, which can be fatal if patients are not stabilized before transport. Chest trauma can be categorized into two areas: Injuries that cause significant blood loss and Injuries that compromise ventilation. 

Primary assessment treatments include:
Manual stabilization of the cervical spine
Establishing and maintaining a patent airway
Determining the patient's level of consciousness using the AVPU scale 
 

Chest injuries can be caused by:
Penetrating trauma, such as gunshots, lacerations, and punctures
Blunt trauma, such as motor vehicle accidents, falls, crush injury, blasts, and burns 

Signs of chest injury include:
Pain in the chest that gets worse when laughing, coughing or sneezing
Pain when breathing in
Difficulty breathing
Tenderness to the chest or back over the ribs
Bruising
Swelling
A 'crunchy' or 'crackling' feeling under the skin or in the ribs
Coughing up blood 

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