injuries poisoning
Rib Fracture
Treatment of Rib Fracture
Analgesia Pulmonary hygiene Treatment of rib fractures usually requires opioid analgesics, although opioids can also depress respiration and worsen Atelectasis . Some clinicians prescribe nonsteroidal anti-inflammatory drugs (NSAIDs) simultaneously. To minimize pulmonary complications, patients should consciously and frequently (eg, hourly while awake) breathe deeply or cough. Holding (essentially splinting) the affected area with the flat palm of the hand or a pillow can minimize the pain during deep breathing or coughing. Patients are hospitalized if they have≥3 fractures or underlying cardiopulmonary insufficiency. Immobilization (eg, by strapping or taping) should usually be avoided; it constricts respiration and may predispose to atelectasis and pneumonia. If patients cannot cough or breathe deeply despite oral or IV analgesics, epidural drug administration or intercostal nerve blocks can be considered. Select patients may benefit from surgical stabilization of rib fractures, particularly for flail chest with respiratory failure or ongoing chest wall instability, deformity, or pain due to nonunion or malunion ( Treatment reference ). 1.Kasotakis G , Hasenboehler EA, Streib EW, et al: Operative fixation of rib fractures after blunt trauma: A practice management guideline from the Eastern Association for the Surgery of Trauma.J Trauma Acute Care Surg82(3), 618-626, 2017. doi: 10.1097/TA.0000000000001350 