What is the treatment for flail chest after intubation?

• A. Positive end-expiratory pressure (PEEP)
• B. High-dose diuretics
• C. Lung-volume reduction surgery
• D. Bronchodilator inhalation only

Answer: (A)

Stabilizing the chest wall and improving oxygenation with positive pressure ventilation is the key concept. In flail chest, a segment of the chest wall moves paradoxically because of several rib fractures, making breathing inefficient and increasing the work of breathing. After intubation, using a ventilator with PEEP raises end-expiratory lung volume and keeps alveoli open, which creates internal pressure that reduces the abnormal inward movement of the flail segment. This internal stabilization helps improve gas exchange and lessen the patient’s breathing effort. The other options don’t address the chest-wall instability: diuretics tackle fluid balance rather than mechanical stability; lung-volume reduction surgery is for chronic disease, not acute injury; bronchodilator inhalation alone won’t fix the chest-wall paradox or recruit damaged lung tissue.