Emergency Medicine Case of the Week
Case #4 -- Flail Chest
Following a Dog Fight
Learning Objectives
| After reviewing this case you will be able to: |
- Recognize a flail chest
- Interpret the arterial blood gases from a dog with a flail chest
- Interpret the radiographic appearance of a dog with a flail chest
- Describe the emergency treatment for a flail chest
|
Patient Profile: "Prince", a 6-year old, intact male,
Sheltie.
History: "Prince" was attacked by a larger dog and developed
severe respiratory distress.
Physical Examination: Heart and pulse rate = 170/minute.
Respiratory rate = panting and distressed. Body weight = 10
kg. "Prince" was in severe respiratory distress and had a paradoxical
thoracic wall motion associated with the ribs and sternum. There were numerous bite
wounds over the thoracic wall.
Laboratory Findings: Arterial blood gases (breathing room air):
pH = 7.440, PCO2 = 29.2, PO2 = 54.8, HCO3
= 19.1, ABE = -2.1, Sat O2 = 86.6, Barometric Pressure = 642.
Thoracic Radiographs:
Click on the radiograph to see an enlargement
Questions:
- Describe the pathophysiology of a flail chest.
- Describe the metabolic/respiratory status and then calculate how well "Prince"
is ventilating and oxygenating.
- Describe the radiographic diagnosis seen in "Prince's" thoracic
radiographs.
- Describe the emergency treatment for a flail chest.
- List some reasons you might have to provide mechanical ventilation for a flail chest.
Answers and Discussion:
Return to Introduction:
Copyright Wayne E. Wingfield, DVM, Colorado State University, 1998. All rights
reserved.
This page was last edited: 09/08/98