A man is brought to casualty who met with A. He sustained multiple rib fractures with paradoxical movement of chest. Management is

Ventilator suppo with IPPV(intermittent positive pressure ventilation) is the treatment of choice.Assisted ventilation is required for several days until the chest wall stabilises.If ventilator suppo is required for more than 10 days,then tracheostomy is done to prevent laryngeal stenosis which can occur due to prolonged endotracheal intubation. Reference:SRB's manual of surgery,5th edition,page no:1116.