Another Film For Your Educational Pleasure

[RESQDOC]

Diagnosis?
FYI, this is a lateral chest film.

http://www.villagephotos.com/pubimage.asp?id_=155028

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Do No Harm. Do Know Harm.

[Reasonable Rascal]

Acute rapid deceleration injury. :smile:
Assuming I am viewing this correctly as a lateral view.

RR

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Knowledge shared is learning gained by both teacher and student.

[RESQDOC]

Fractured sternum after being wiped off out of control horse by tree branch (just like in the movies!)

Cardiac contusion, watched in ICU overnight, a few PVC's & SOB secondary to pain, did fine.

Palapable step off deformity on chest + contusions. You can reduce these but generally should get an angiogram first to confirm no heart injury. Or you can just leave it, it will calcify together and usually causes no problems at all.

In an austere environment injuries such as this should be closely watched for evidence of pulmonary and/or cardiac contusions (SOB, hemoptysis, respiratory distress, hemo/pneumothorax, pulse irregularity, etc.) and treated accordingly, and otherwise should do fine, no lifing hard manual labor for 6-12 weeks to allow healing.

[Reasonable Rascal]

Horse! I should have known. I was thinking steering wheel.

RR

[RESQDOC]

All the others I have seen have been steering wheels, including 1 DOA from coronary artery laceration...

[cayoung]

Was pt standing upright at time of film? If so, we'd guess he had a bit of belly. That didn't help. Hmm. Wiped off a horse by tree branch. I'd expect further damage to butt, when he landed. Secondary, don't you know.

No heavy lifting sounds like great Rx.

Hope things improve rapidly for the fellow.