Treatment for flail chest

I am currently in an EMT class and we were taught to use a bully dressing on the side of the injury.
 
Yup. Treatment hasn't changed much since 5 years ago, when this thread was last replied to...
 
PeskyHotDog said:
I am currently in an EMT class and we were taught to use a bully dressing on the side of the injury.
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Was that dressing being mean to all the others in the jump bag?
 
Wow. There are some terrifying replies from earlier in this thread.

Tension pneumo, flail chest...Eh, what's the difference anyway? I know they both involve the chest-ish area so clearly they should be treated identically [emoji6]
 
Yikes...I had no idea there were people saying don't splint a flail chest....my EMT class basically taught us flail chest=paradoxical movement, paradoxical movement = flail chest and that in our trauma assessment scenarios if we found paradoxical movement we splint it with a big, bulky trauma dressing taped onto the chest over the injury.

What really got me were some of the replys on the first page mentioning "oh the people who took PHTLS already knew not to do this...." Kinda surprised me since I just did PHTLS a few weeks ago. Granted PHTLS teaching priorities have probably changed in the last ten years or so when those replays were wrote lol but my class spent pretty much no time on specific treatments and a lot of time on assessments but I definitely DON'T remember them saying don't treat a flail chest with a big, bulky trauma dressing taped in place over the injury....

So I just double checked my EMT textbook, my PHTLS textbook and even my Paramedic textbook I have (I do plan on going soon-ish! Lol) and they all pretty much say treat with position of comfort, supplemental oxygen, be prepared to BVM, and diesel bolus to the trauma center...the EMT text says "the patient may find it easier and less painful to breathe if the flail segment is immobilized. You can tape a bulky pad against that segment of the chest for this purpose, although taping too tightly will also prevent adequate ventilation". The paramedic text however disagrees by simply saying "Field stabilization of the flail segment is not recommended" and then goes on to talk about being prepared to ventilated. PHTLS text does agree by saying "efforts to stabilize the flail segment with sandbags or other means that may further comprise chest wall motion and, thus, ventilation are contraindicated".

Funny how the EMT curriculum is basically teaching the exact opposite as what the Paramedic and PHTLS textbooks are saying (even the EMT textbook itself seems to shy away from automatically taping the bulky dressing on, yet that's what they drilled into our heads in lecture :/
 
Huh, Wikipedia covers flail chest better than the EMT textbook.
 
We were taught occlusive dressing taped on one side (or leave a corner open) to let excess air out, control bleeding as much as you can and book it to the hospital. Ps can probably do a lit more though.
 
Amelia said:
We were taught occlusive dressing taped on one side (or leave a corner open) to let excess air out, control bleeding as much as you can and book it to the hospital. Ps can probably do a lit more though.
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facepalm.jpg
 
For the record, that is what Brady EMT 12th edition says. And I will learn the protocol and do whatever they say. Because if I get the job they will pay me so I have to keep them as happy as a cat with a can opener.
 
Amelia said:
We were taught occlusive dressing taped on one side (or leave a corner open) to let excess air out, control bleeding as much as you can and book it to the hospital. Ps can probably do a lit more though.
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Flail chest is not a suckling chest wound.
 
Sucking chest wound - put a defibrillation pad over it

Flail chest - do nothing specific, support ventilation, it tensioning do a thoracostomy.
 
DesertMedic66 said:
Apparently my phone has heard of a suckling chest wound before. However I have not haha.
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Joking aside, it is scary to think that there are multiple people, whom i am assuming treat patients on a regular basis, that can't even tell the difference between a flail chest and an open pneumothorax.
 
redundantbassist said:
Joking aside, it is scary to think that there are multiple people, whom i am assuming treat patients on a regular basis, that can't even tell the difference between a flail chest and an open pneumothorax.
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To be fair, they probably don't encounter those conditions on a regular basis.
 
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