Blunt force trauma, flail of the thorax, haemoneumothorax, pulmonary contusion, pericardial tamponade, shock, respiratory shock, haemorrhagic shock and brake or fracture. Steve complains of 8/10 pain in his left leg, it is clearly deformed, it is a potential fracture or dislocation. This is not a life-threatening injury, but a serious distracting injury. One of the patient's primary injuries is the 12 cm contusion on the left axial/anterior chest with pain 8/10. When excessive blunt force trauma is applied to the chest wall above the body's tolerance, the musculoskeletal system that protects vital organs will fail. “This blunt trauma can lead to failed chest syndrome”…(Aaron MR at el 2001), pulmonary contusion, heamothorax or pneumothorax, and aortic rupture. The first rib and the manubrium are attached to each other and move in unison. The first rib is short and protected by the clavicle. Fracture of this rib indicates significant force application to the chest wall. Luckily there is no visible sighting of the flagellated chest; Thoracic flail occurs when a series of adjacent ribs are fractured in at least 2 consecutive places, either anteriorly or posteriorly. “This section of the chest wall detaches from the main structure and moves during spontaneous inspiration/experience. The physiological impact of a flail breast depends on multiple factors, including the size of the flail segment and internal damage”... Davignon, K., Kwo, J., & Bigatello, L.M. (2004).If a rib breaks plural space this can cause pneumothoraxNormally the pleural space has a negative pressure which allows the parietal and visceral pleura to expand in time with the diaphragm and draw air into the lungs. As the chest wall expands outward, surface tension... center of paper... consider the possibility of gastrointestinal hemorrhage. Gastrointestinal bleeding is a contraindication because the bleeding is not contained in the body and can leak. through one of the orifices. We can administer 20 ml/kg of NaCl+ up to HR <100 and blood pressure >100. If no signs of improvement are seen, fluid therapy will be stopped. Works Cited http://www.sassit.co.za/Journals/Trauma/Chest%20trauma/flail% 20chest.pdfAaron MR,Johnathan AJ,Timmothy RG 2001 management of the recovered flat chest http://www.sassit.co. za/Journals/Trauma/Chest%20trauma/flail%20chest.pdfDavignon, K., Kwo, J., & Bigatello, L.M. (2004). Pathophysiology and management of thoracic scourge. Minerva anestesiologica, 4, 193–199.Trauma.org, 2004. TRAUMA.ORG: Thoracic trauma. retrieved: http://www.trauma.org/archive/thoracic/CHESTcontusion.htmlRichter T, Ragaller M. 2011Ventilation in chest trauma. J Emergent trauma shock.;4(2):251-9.