Flail chest refers to a serious breech in the integrity of the ribcage from more than one adjacent broken ribs broken in more than one place each. Instead of rigidly holding the normal shape of the chest, flail chest results in a segment of the chest wall flailing back and forth in the opposite direction of the rest of the chest wall.
This is a dangerous injury that requires emergency medical treatment. If not treated promptly, flail chest can lead to a collapsed lung or blood around the heart. Act swiftly.
Time Required: ASAP
- Stay Safe. If you are not the victim, practice universal precautions and wear personal protective equipment if available. Be sure that whatever caused the injury to the victim is no longer a threat.
- Call 911. If the 911 operator gives instructions, follow those instructions and ignore the rest of this page. If 911 is not available, get the victim to emergency medical help as soon as possible.
- Stabilize the flail chest. Use a pillow to put pressure on the flail segment. Holding the flail segment in place keeps it from moving in an opposite direction as the surrounding muscle and bone. If it doesn't move, it won't cause more damage to the heart, lungs and surrounding tissues.
- If a pillow is not available, almost anything will do to stabilize the flail chest. Roll up a jacket or a blanket. If there is absolutely nothing available, at least have the victim lie on the affected side of the chest to discourage it from moving.
- Regardless how a flail chest is treated it is going to hurt, probably worse than anything the victim has ever encountered. Over the counter pain medications aren't going to do much for this level of pain and stronger painkillers aren't a good idea until emergency medical help is available to provide the full range of emergency treatment. Never take -- or give to another victim -- someone else's prescription medications.
- Always make sure that victims of flail chest get to emergency medical treatment. Failure to provide proper treatment for flail chest can lead to pneumonia and other life-threatening conditions.
Henry, Mark C., and Edward R. Stapleton. EMT Prehospital Care. 3rd Ed. 2004. Mosby/Jems
Pettiford, B.L., J.D. Luketich and R.J. Landreneau. "The management of flail chest." Thorac Surg Clin. 2007 Feb;17(1):25-33