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Flail chest - why holding the side?


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The chest wall is very elastic and the relaxed position for the wall is with the lungs deflated. Think of an elastic band wrapped around a plastic bag. If you inflate the bag the rubber band will expand, but once you stop inflating, the elastic band forces the air out of the bag until there is just a little air left in it. (retained dead space air) Now, wrap 12 elastic bands around the bag. (ribs) If you break three of the elastics(flail segment) you can see there is more air left behind in the bag when the other elastics constrict it. This results in a reduction in air movement into the lungs.

By using your hand to splint the flail segment you are returning the elastics to the chest wall and assisting in the exhalation of the air from the lungs.

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