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The Scenario:
Cathy gets most of her exercise on a mountain bike. She lives in North Carolina and loves to get way up into the mountains on a weekend. More than the speed, she loves the rocky, watery, technical terrain to be found there.
She had been traveling about two hours from where the car was parked when she had her accident. She was weaving through a wooded area of evergreens; large trees with wet pine needles had covered the ground after a recent rain. The front tire crossed a slippery root and she slammed down onto her side before she could protect herself. The right side of her ribs hit the root very hard. The wind was knocked out of her and she couldn't breathe for five or ten seconds. She felt tremendous pain in her side. Slowly, her breath came back, and as she walked around her breathing returned to normal. She was scratched and bruised but she could see no cuts in the skin. Finally, she was able to climb back on her bike, and she headed back for the car.
Within about 15 minutes of downhill riding she began to feel increasingly short of breath. Then, her shortness of breath was way out of proportion to her exertion. The pain in her chest was still strong, but she couldn't believe how hard it was to breathe. Something was wrong.
Question:
Answer:
Cathy could be in trouble. What she probably has is a collapsed right lung. The medical term for that is pneumothorax. A simple pneumothorax means that the lung is simply collapsed on one side, causing shortness of breath, but leaving the other lung unaffected. More serious still is a tension pneumothorax. In this instance, air is leaking from the punctured lung into the chest cavity with every breath and getting trapped there. This air "outside the lung" begins to accumulate under pressure, causing collapse of the lung on one side, and then actually pushes the contents of the middle portion of the chest (heart, food tube, wind-pipe, blood vessels) towards the other side, causing collapse there too. This is a true emergency.
The best thing is to get her to a medical facility ASAP. If a person with training in emergency care were nearby, they might know how to use a hollow tube such as a Bic pen and -- get ready for this -- force it through the chest wall between the ribs to let out the trapped air. A brutal but potentially life-saving experience. (Please don't try this unless you've had the training.)
Some respondents suggested that she might also be bleeding into her chest cavity, causing collapse of the lung that way. This is certainly possible. A fractured rib or two is also very possible.
Fortunately, an injury like this is uncommon. But mountain bike injuries are not. Think about bringing a buddy along.
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