Complications and emergencies: flail chest: practice question

A Anaesthesia question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Anaesthesia · Complications and emergencies: flail chest

Sample item

A 58-year-old with five consecutive right rib fractures has paradoxical chest movement, pain-limited breathing and an SpO2 of 90 percent. Which measure is most important in management?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Regional analgesia such as thoracic epidural or paravertebral block, with oxygen and physiotherapy

Hypoxia in flail chest results mainly from the underlying pulmonary contusion and splinting from pain. Good analgesia allows deep breathing and coughing, and ventilation is reserved for failure of this approach.

Option by option

  • A. Opioid sedation to suppress respiratory effort and pain

    Sedation depresses ventilation and does not treat the cause.

  • B. Tight strapping of the chest wall to splint the unstable segment

    Strapping restricts expansion and worsens hypoventilation.

  • C. Routine prophylactic intubation and ventilation in all such patients

    Not every patient needs ventilation, and it brings its own risks.

  • D. Regional analgesia such as thoracic epidural or paravertebral block, with oxygen and physiotherapy (correct)

    Correct. Analgesia is the cornerstone and improves ventilation.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Anaesthesia question

What is the answer to this Anaesthesia question?

The best answer is D, Regional analgesia such as thoracic epidural or paravertebral block, with oxygen and physiotherapy. Hypoxia in flail chest results mainly from the underlying pulmonary contusion and splinting from pain.

Why is "Opioid sedation to suppress respiratory effort and pain" not the answer?

Sedation depresses ventilation and does not treat the cause.

Why is "Tight strapping of the chest wall to splint the unstable segment" not the answer?

Strapping restricts expansion and worsens hypoventilation.

Why is "Routine prophylactic intubation and ventilation in all such patients" not the answer?

Not every patient needs ventilation, and it brings its own risks.

What concept does this question test?

It tests Complications and emergencies: flail chest in Anaesthesia. Good analgesia allows deep breathing and coughing, and ventilation is reserved for failure of this approach.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Complications and emergencies: flail chest?

Make a table of each agent, its key advantage and its main side effect. Then use the flashcards and the other Anaesthesia questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.