Come Spend a Night in the ER

Case #4

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:

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Copyright Wayne E. Wingfield, DVM, Colorado State University, 2000. All rights reserved.
This page was last edited:  08/24/00