What is a potential sign of a flail chest in a trauma patient?

A potential sign of a flail chest is unequal chest expansion. Flail chest occurs when multiple adjacent ribs are fractured in two or more places, leading to a segment of the chest wall that moves independently from the rest of the thoracic cavity. This results in a paradoxical motion during respiration; when the patient inhales, the flail segment may retract inward rather than expand outward, while the rest of the chest wall expands. Consequently, this imbalance leads to unequal chest expansion between the affected side and the unaffected side.

Recognizing this sign is critical in trauma assessment since it can indicate underlying respiratory instability and the need for immediate medical intervention. Monitoring for other symptoms associated with a flail chest, such as difficulty breathing or increased work of breathing, can also provide additional insights into the patient's condition.