Paradoxical chest movement is when the normal chest movements of respiration are reversed, with the chest wall moving in during inspiration and out during expiration. Also known as paradoxical breathing, it is a sign that the patient is unable to move air properly.
Paradoxical chest movement is most commonly seen as a result of a flail chest, which is when adjacent ribs are broken in more than one place, causing the injured segment of ribs to break away and move independently from the rest of the rib cage. A pneumothorax, or collapsed lung, can also cause paradoxical chest movements.
Paradoxical chest movement can also be seen in patients who have foreign objects obstructing their airways. The obstruction causes the chest to move inward as the diaphragm lowers in an attempt to fill the lungs with air that cannot pass. Similarly, children in respiratory distress, patients with sleep apnea and patients with end-stage chronic obstructive disorders may also have paradoxical chest movements because they attempt to move air around an obstruction.
Paradoxical chest movements are a clear sign that normal breathing is not taking place, and as such, are a life-threatening emergency. Anyone experiencing paradoxical chest movements should seek emergency medical attention immediately.