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40040 Surgery

A 35-year-old man met with a car accident in which his chest struck the steering wheel of his car. He is brought to the emergency with stable vital signs and no respiratory distress but multiple rib fractures are palpable and right side of the chest shows paradoxical movement. Chest x-ray rules out any pneumothorax or hemothorax. What is the most appropriate initial management in this case?

AAnalgesia, chest physiotherapy, & observation
BIntubation & mechanical ventilation
CStabilization of the chest wall
DImmediate operative stabilization
Surgery
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