Which term defines a closed chest injury that occurs when two or more adjacent ribs are fractured in two or more places and become free floating?

• A. Follow through
• B. Evacuation care
• C. Evasion
• D. Flail chest

Answer: (D)

A flail chest is a closed chest injury that happens when two or more adjacent ribs are fractured in two or more places, creating a free-floating segment of the chest wall. Because that segment is detached, it moves paradoxically during breathing—moving inward on inspiration and outward on expiration—while the rest of the chest expands, which can severely impair ventilation. This injury carries a high risk of respiratory failure and complications like pneumothorax or pulmonary contusion, so it requires prompt assessment and supportive care such as oxygen and airway/ventilation support as needed. In the field, treat with careful stabilization and avoid applying pressure to the fractured area, and move the patient for definitive care. The other terms don’t describe this chest-wall injury or its mechanism.