What is a pulmonary contusion?
A pulmonary contusion is bruising or bleeding of your lung tissue that may cause pain and trouble breathing. It is a common lung injury after a blunt trauma to the chest. The force of the trauma may cause bleeding and swelling inside one or both of your lungs.
What are the signs and symptoms of a pulmonary contusion?
You may have more than one of the following:
- Chest pain
- Trouble breathing
- Coughing up blood or large amounts of watery sputum (spit)
- Fast and shallow breathing
- High-pitched wheezing when you breathe out
How is a pulmonary contusion diagnosed?
Your caregiver will examine you and ask you about your symptoms. He will also watch and listen to how you breathe. He will ask about any injuries you have had and check your chest area for bleeding, bone fractures, or punctures in your skin.
- Arterial blood gases (ABG): Your blood is tested for the amount of oxygen, acids, and carbon dioxide it contains.
- Chest x-ray: It may take up to 6 hours after your injury before a pulmonary contusion can be seen on an x-ray. Caregivers will look for bruises or other injuries in your lungs.
- Ultrasound: This machine uses sound waves to show pictures of your organs and tissues on a monitor. An ultrasound may be done to show if you have fluid, swelling, or bruises in your lungs.
- CT scan: This test is also called a CAT scan. An x-ray machine uses a computer to take pictures of your chest. The pictures may show areas that are bleeding, or broken bones. You may be given a dye before the pictures are taken to help caregivers see the pictures better. Tell the caregiver if you have ever had an allergic reaction to contrast dye.
How is a pulmonary contusion treated?
Your treatment will depend on how severe your injury is. Caregivers will use different treatments to help you breathe easier and get enough oxygen into your body. You may need more than one of the following:
- Pain medicines: These are used to decrease your pain and make it easier for you to breathe. You may be given pain medicine as a shot, in your IV, or through an epidural (a small tube inserted into your back).
- Breathe deeply and cough: This helps to open the air passages and bring up sputum from your lungs. You can breathe deeply and cough on your own, or with the help of an incentive spirometer. An incentive spirometer is a device that can help you take deeper breaths.
- Oxygen: You may need extra oxygen if you have difficulty breathing. You breathe the oxygen through a face mask or a nasal cannula. A nasal cannula is a pair of short, thin tubes that rest just inside your nose.
- Suctioning: This is done to remove any blood or mucus that is blocking your air passages. Caregivers may insert a tube connected to a suction machine into your mouth, nasal passages, or ET tube.
- Chest tube: A chest tube is used to remove air, blood, or fluid from around your lungs or heart. This lets your lungs fill with air when you breathe, and helps your heart beat normally. A tube may be inserted through an incision in your chest to drain the air or fluid. The chest tube is attached to a container to collect the blood or fluid.
- Noninvasive positive-pressure ventilation: This is a machine that will help you breathe. The machine gives you air through a mask or mouthpiece. If a mask is used, it may go over your nose and mouth, or just your nose.
- Mechanical ventilation: You may need this if you cannot breathe properly. Caregivers may put an endotracheal (ET) tube into your mouth and throat to keep your trachea (windpipe) open and help you breathe. The tube will be connected to a ventilator (breathing machine) to help you breathe and get enough oxygen.
What are the risks of a pulmonary contusion?
- Pressure from the oxygen mask may cause your skin to break down. You may also have abdominal swelling from swallowing air. If you need a breathing tube, you may have an increased risk of lung infection. Mucus in your lower airway may block air and cause your lung tissue to break down and bleed. Even with treatment, injuries causing your pulmonary contusion may be life-threatening.
- If left untreated, a pulmonary contusion may cause your lungs to fail or collapse. When this happens, your lungs may not fill up with air, and you will have trouble breathing. You may also have an increased risk of lung infection if your lungs do not work properly. You may have other life-threatening injuries that cause you to bleed or stop breathing.
When should I contact my caregiver?
Contact your caregiver if:
- You have a fever.
- Your skin becomes red, itches, and you develop a rash after you take your medicines.
- You have questions or concerns about your condition or care.
When should I seek immediate care?
Seek care immediately or call 911 if:
- You cough up blood.
- You feel dizzy, lightheaded, or faint.
- You have trouble breathing.
- You have chest pain or a heavy feeling in your chest that lasts more than a few minutes.
- You have pain that starts in your chest then spreads to your shoulders, neck, or arms.
You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.
© 2013 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of the Blausen Databases or Truven Health Analytics.
The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.
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