A pre-hospital team encounters a patient who has been involved in a high-speed RTC. The patient has a flail segment over the left chest and paradoxica...

Question

A pre-hospital team encounters a patient who has been involved in a high-speed RTC. The patient has a flail segment over the left chest and paradoxical chest wall movement. He is haemodynamically stable with SpO2 of 95% on high-flow oxygen. He is in significant pain. Which analgesic approach is most appropriate for this patient?

Accepted Answer

Multimodal analgesia: IV opioid (morphine or fentanyl) titrated to pain PLUS consider an intercostal nerve block or serratus anterior plane block if trained - effective analgesia is essential to prevent splinting and respiratory deterioration

Answer

NSAIDs are first-line for chest wall injury

Answer

Paracetamol 1 g oral only

Answer

No analgesia - pain assessment is needed for ongoing monitoring

Answer

Entonox alone - it provides sufficient analgesia for flail chest

uk-dipimc MCQ (SBA): Flail Chest - Multimodal Analgesia