Author(s): DouglasComeau, DO, CAQSM, FAAFP and Angelene M.Elliott, DO
Description
Epidemiology
Etiology and Pathophysiology
Blunt trauma to the chest causing disruption of alveolar capillary interface, resulting in collection of blood, edema, and protein in the interstitium and alveoli which can lead to bronchospasm, increase in production and decrease of clearance of mucus, and decrease in production of surfactant, resulting in possible pulmonary dysfunction like ventilation/perfusion mismatch, increase in intrapulmonary shunt, increase in lung fluid, and loss of lung compliance. This results in damaged lung that is unable to exchange gas effectively in respiration.
Risk-Factors
General Prevention
Use protective equipment and padding appropriate for the activity, such as seat restraints in motor sports to prevent ejection:
Commonly Associated Conditions
Diagnosis is suspected when an athlete sustains a blunt trauma to the chest and has respiratory difficulty:
History
Physical Exam
Differential Diagnosis
Diagnostic Tests & Interpretation
Initial Tests (lab, imaging)
Diagnostic Procedures/Other
If hemoptysis is recurrent over >48 hr, bronchoscopy may be considered, depending on clinical status (8):
Medication
Additional Therapies
Admission, Inpatient, and Nursing Considerations
Follow-up Recommendations
Prognosis
Complications
Dubinsky I, Low A. Non-life-threatening blunt chest trauma: appropriate investigation and treatment. Am J Emerg Med. 1997;15(3):240–243.