How to Stabilize the Crushed Thorax
In patients with crushed thorax, flail chest may result if more than four ribs are broken, more than 3 times each. The impaired ventilation of the spontaneously breathing patient results in hypoxemia after a short time, but occurs immediately if there are additional pulmonary lesions; “Pendelluft” phenomenon does not occur. Therapy is based on clinical signs but mainly on serial arterial blood gas analyses and vital capacity measurements. Assisted ventilation is indicated if vital capacity cannot be increased above 15 ml/kg body wt. by conservative methods.