DwayneEMTP Posted November 1, 2010 Posted November 1, 2010 What is flail chest? What caused it? What are your primary short term concerns? Longer term concerns? Load and go/stay and play? Why? Treatment? Please folks, if you know all of the above answers, please don't ruin it for those that can learn by asking and exploring. We already know you're smart. To the rest that are familiar with this, please feel free to jump into this thread in a mentor-ish way and help it move along if you would. I have no info on this patient so we're going to deal with him in gross terms only, OK? Dwayne 1
Richard B the EMT Posted November 1, 2010 Posted November 1, 2010 Seems you hit a motherlode. I had no previous idea that YouTube had a subsidiary called Medical Tube, via the YT site.
HERBIE1 Posted November 1, 2010 Posted November 1, 2010 Wow! Textbook example, Dwayne. It doesn't get any more obvious than that. Can't wait to hear about mechanism of injury.
fakingpatience Posted November 1, 2010 Posted November 1, 2010 Wow, I've never actually seen the paradoxical movement before! Is it usually that pronounced?
DwayneEMTP Posted November 1, 2010 Author Posted November 1, 2010 Actually I don't know anything about this guy, but from the video I'm pretty confident that I know how he ended up here. In the past we've had some pretty brave and adventurous BLS/New to ALS providers that liked to jump in and explore these types of things. I just wish I had more info. Perhaps those of you that have more experience with this type of injury can help field questions? I've only see it twice since being a medic so am certainly no expert. C'mon folks. Those of you that have looked, but are afraid you're too stupid to play? You're not. This is a pretty simple/complex type of case. What say you? Dwayne Note. I originally found it here.. http://www.medicalvideos.us/ and may, or may not have misrepresented myself as a physician to get it, though after having done, or not done so I don't think it was, or wasn't necessary to gain access to the site. Just sayin'...
mobey Posted November 1, 2010 Posted November 1, 2010 Wow, I've never actually seen the paradoxical movement before! Is it usually that pronounced? frick... lost my post.. Grrr I am not a expert either, but I feel comfortable in saying, no, they are not usually that pronounced in the field. As with any other fracture, the muscles around the flail segment spasm and "splint" the flail. There is a possibility you may not even know there is a flail while the pt is with you. IMO, the paradoxical movement is a delayed sign. Of course, neurological imparement will effect the spasm.
paramedicmike Posted November 1, 2010 Posted November 1, 2010 I'm not answering the questions. I'll leave that for others. I'm just here to jump on the "that's an awesome video!" bandwagon. Nice find, indeed... ... doctor.
DwayneEMTP Posted November 1, 2010 Author Posted November 1, 2010 I've seen it twice, and once was almost a duplicate to the video, the second, as Mobey stated, just looked like a strange swelling under the pectoris muscle. I'm guessing due to splinting secondary to spasm, though that didn't occur to me at the time. My official working diagnosis for that injured part was, "Wow, that's weird, better keep an eye on it." I was told of the diagnosis later at the ER. Can you take a run at the rest of the questions FP? I'm proud, though not surprised to see you being the first to jump in. And Mike, that Pararescueman technical specialist ninja to you... Doctors only wish they could be so macho. (Some AF guy is going to see my badge and beat the shit out of me...I just know it.) Dwayne
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