The main problem that occurs with pylmonary contusion is inadequate ventilation from injured parenchyma. Severe pulmonary contusion should be man-
Fig 19.10. Bronchogram of a patient sustaining a left mainstem bronchial tear. The injury was initially missed on flexible bronchoscopy. Bronchography revealed occlusion of the left lower lobe bronchus. Subsequent bronchoscopy confirmed a spiral tear in the left mainstem bronchus occluding the lower lobe orifice.
aged with endotracheal intubation and ventilation. This may not always be necessary and the patient can sometimes be managed with pulmonary toilet including percussion and postural drainage, bronchodilator therapy and deep breathing exercises.
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If you suffer with asthma, you will no doubt be familiar with the uncomfortable sensations as your bronchial tubes begin to narrow and your muscles around them start to tighten. A sticky mucus known as phlegm begins to produce and increase within your bronchial tubes and you begin to wheeze, cough and struggle to breathe.