Chest Trauma — Flail, Pneumothorax, Hemothorax

A 32-year-old man presents to the emergency department following a motor vehicle collision with severe left-sided chest trauma. On examination, he has tachycardia (HR 118/min), hypotension (BP 92/58 mmHg), absent breath sounds on the left, and severe respiratory distress. Bedside assessment suggests a large left-sided pneumothorax with haemodynamic compromise. Which investigation is the most appropriate next step?

A 28-year-old man is brought to the trauma centre 2 hours after a stab wound to the left anterior chest (5th intercostal space, midaxillary line). He is haemodynamically stable (BP 128/82 mmHg, HR 94/min), with normal breath sounds bilaterally and no external bleeding. On examination, there is a small puncture wound with minimal surrounding erythema. Bedside FAST is negative. Which investigation is most appropriate to exclude occult haemothorax and pneumothorax?

In flail chest, the paradoxical movement of the flail segment during respiration is due to which of the following mechanisms?

A 28-year-old man is brought to the trauma centre with a tension pneumothorax following blunt chest trauma. He is hypotensive (BP 90/60 mmHg), tachycardic (HR 128/min), with absent breath sounds on the left and tracheal deviation. After immediate needle decompression, a chest tube is placed. Which agent is the drug of choice for analgesia and sedation during chest tube insertion in this haemodynamically unstable patient?

A 32-year-old man is brought to the emergency department following a motor vehicle collision with blunt chest trauma. Clinical examination reveals paradoxical breathing, severe chest wall pain, and crepitus. Chest X-ray confirms multiple rib fractures with flail chest. Regarding the management of flail chest, all of the following are true EXCEPT: