Pulmonary Contusion

Pulmonary contusion is a bruise of the lung tissue caused by blunt force to the chest. It happens most often after motor vehicle collisions, falls, sports injuries, physical assaults, and crush or blast injuries. The lung looks intact from the outside, but underneath the injured area small blood vessels and air sacs have been torn and are leaking blood and fluid into the lung. For the practical nurse, the most important idea to hold onto is that a pulmonary contusion usually gets worse before it gets better. A patient who looks stable when they arrive can become short of breath and low on oxygen over the next one to three days as the bruised lung continues to swell and fill with fluid. This is why steady monitoring, good breathing support, careful fluid handling, and quick escalation matter so much. The practical nurse does not diagnose the injury, but the practical nurse is often the person at the bedside who notices the first signs that the patient is heading in the wrong direction.