Man With Blunt Chest Trauma

A 36-year-old man presented to the emergency department after a work-related injury in which he was operating a piece of machinery and became pinned between 2 pieces of metal. The initial examination showed superficial abrasions and a deformity of a segment of the left chest wall with paradoxical movement (Figure 1, Video E1). On arrival, the patient was in significant pain but maintaining oxygenation on room air; however, supplemental oxygen was provided. Chest radiograph (Figure 2) showed a left-pneumothorax, left-sided pulmonary contusions, small left-sided hemothorax, and numerous left-sided rib fractures.