Clinical management of blunt trauma patients with unilateral rib fractures: A randomized trial

1995 ◽  
Vol 19 (3) ◽  
pp. 388-393 ◽  
Author(s):  
Sheryl G. A. Gabram ◽  
Robert J. Schwartz ◽  
Lenworth M. Jacobs ◽  
Denise Lawrence ◽  
Marlene A. Murphy ◽  
...  
Keyword(s):  
Randomized Trial ◽  
Blunt Trauma ◽  
Clinical Management ◽  
Rib Fractures ◽  
Trauma Patients

THE CLINICAL MANAGEMENT OF BLUNT TRAUMA PATIENTS WITH UNILATERAL MULTIPLE RIB FRACTURES

1991 ◽  
Vol 31 (12) ◽  
pp. 1716
Author(s):  
S Gabram ◽  
R Schwartz ◽  
L Jacobs ◽  
D Lawrence ◽  
W Kantor ◽  
...  
Keyword(s):  
Blunt Trauma ◽  
Clinical Management ◽  
Rib Fractures ◽  
Trauma Patients ◽  
Multiple Rib Fractures

Outcomes after rib fractures in geriatric blunt trauma patients

2018 ◽  
Vol 215 (6) ◽  
pp. 1020-1023 ◽  
Author(s):  
Rahman Barry ◽  
Errington Thompson
Keyword(s):  
Blunt Trauma ◽  
Rib Fractures ◽  
Trauma Patients

Rib Fractures and Mortality: Breaking the Causal Relationship

2019 ◽  
Vol 85 (11) ◽  
pp. 1224-1227 ◽  
Author(s):  
Brittany Bankhead-Kendall ◽  
Sepeadeh Radpour ◽  
Kevin Luftman ◽  
Erin Guerra ◽  
Sadia Ali ◽  
...  
Keyword(s):  
Blunt Trauma ◽  
Injury Severity ◽  
Rib Fractures ◽  
Rib Fracture ◽  
Direct Result ◽  
P Value ◽  
Trauma Patients ◽  
Injury Score ◽  
Urban Level ◽  
Level I

Rib fractures have long been considered as a major contributor to mortality in the blunt trauma patient. We hypothesized that rib fractures can be an excellent predictor of mortality, but rarely contribute to cause death. We performed a retrospective study (2008–2015) of blunt trauma patients admitted to our urban, Level I trauma center with one or more rib fractures. Medical records were reviewed in detail. Rib fracture deaths were those from any respiratory sequelae or hemorrhage from rib fractures. There were 4413 blunt trauma patients who sustained one or more rib fractures and 295 (6.8%) died. Rib fracture patients who died had a mean Injury Severity Score = 38 and chest Abbreviated Injury Score = 3.4. Rib fractures were the cause of death in only 21 patients (0.5%). After excluding patients who were dead on arrival, patients dying as a result of their rib fractures were found to be older ( P < 0.0001) and had a higher admission respiratory rate ( P = 0.02). Multivariable logistic regression found that age ≥65 was the only variable independently associated with mortality directly related to rib fractures (odds ratio 4.1, 95% confidence interval = 1.3–13.3, P value < .0001). Mortality in patients with rib fractures is uncommon (7%), and mortality directly related to rib fractures is rare (0.5%). Older patients are four times more likely to die as a direct result of rib fractures and may require additional resources to avoid mortality.

1548: OUTCOMES AFTER RIB FRACTURES IN GERIATRIC BLUNT TRAUMA PATIENTS

2016 ◽  
Vol 44 (12) ◽  
pp. 462-462
Author(s):  
Rahman Barry ◽  
Errington Thompson
Keyword(s):  
Blunt Trauma ◽  
Rib Fractures ◽  
Trauma Patients

Predictors of Dependency in Geriatric Trauma Patients with Rib Fractures: A Population Study

2018 ◽  
Vol 84 (12) ◽  
pp. 1856-1860 ◽  
Author(s):  
Alexandra E. Halevi ◽  
Elizabeth Mauer ◽  
Pierre Saldinger ◽  
Daniel J. Hagler
Keyword(s):  
Blunt Trauma ◽  
Financial Burden ◽  
Skilled Nursing Facility ◽  
Multivariable Analysis ◽  
Rib Fractures ◽  
Geriatric Trauma ◽  
Trauma Patients ◽  
Nursing Facility ◽  
Skilled Nursing ◽  
Trauma Population

The geriatric trauma population is unique. These patients are at risk of being discharged to rehabilitation or a skilled nursing facility, instead of being returned to their homes, placing a significant burden on both the patient families and society. This study evaluated which patient characteristics increase the likelihood of a previously independent geriatric blunt trauma becoming functionally dependent and being discharged to a location other than home. Data were extracted from the National Trauma Data Bank from 2012 to 2014 for blunt trauma patients ≥65 years old, admitted from home, with one or more rib fractures. Primary outcomes were discharge home versus a facility. Subgroup analysis evaluated disposition to acute short-term rehabilitation or subacute rehabilitation or skilled nursing facility. Multivariable analysis was used to calculate probabilities of disposition based on the above variables, controlling for comorbidities. Sixteen thousand six hundred thirty-two patients were included. Only 58 per cent were discharged home. Increased age, ≥4 rib fractures, white race, and female gender were found to increase the risk of discharge to a facility. In addition, patients with chronic renal failure, history of diabetes, obesity, or heart failure were less likely to be discharged home. This study shows that age, gender, race, and the number of rib fractures are statistically significant in predicting which patients are less likely to be discharged home. This reinforces the need for the development of triage and treatment protocols in this higher risk population, to decrease the social and financial burden of these injuries.

Efficacy of serratus anterior plane block in pain control in traumatic posterior rib fractures: A case series

Trauma ◽  
2021 ◽  
pp. 146040862110467
Author(s):  
Paramvir Singh ◽  
Ashish Sakharpe ◽  
Jasmeen Kaur ◽  
Anterpreet Dua ◽  
Shvetank Agarwal ◽  
...  
Keyword(s):  
Blunt Trauma ◽  
Pain Control ◽  
Case Series ◽  
Pulmonary Complications ◽  
Rib Fractures ◽  
Trauma Patients ◽  
Serratus Anterior ◽  
Body Habitus ◽  
Multiple Rib Fractures ◽  
Anterior Plane

Blunt trauma patients commonly present with multiple rib fractures, which increases overall morbidity and mortality due to pulmonary complications. Effective chest wall analgesia may be challenging due to positioning difficulty, body habitus, anticoagulation issues with neuraxial interventions, etc. Serratus anterior plane block has been shown to be beneficial in anterior and lateral rib fractures in recent studies. We propose the efficacy of this block in posterior rib fractures as well, through this small case series of blunt trauma patients with posterior rib fractures, reporting significant pain relief after the block.

scholarly journals LO48: Does FAST change management of blunt trauma patients?

CJEM ◽  
2018 ◽  
Vol 20 (S1) ◽  
pp. S23-S23 ◽  
Author(s):  
R. Thavanathan ◽  
I. G. Stiell ◽  
O. Levac-Martinho ◽  
J. Worrall ◽  
B. W. Ritcey
Keyword(s):  
Blunt Trauma ◽  
Clinical Management ◽  
Trauma Team ◽  
Whole Body ◽  
Trauma Patients ◽  
Health Records ◽  
Team Assessment ◽  
The Impact ◽  
Definitive Management ◽  
Fast Group

Introduction: Despite widespread use of FAST in trauma, there is a lack of data supporting its usefulness. We sought to identify the impact of FAST on clinical management of blunt trauma patients. Methods: This health records review was conducted at a single large academic Level 1 trauma center emergency department. Patients with a suspicion of acute blunt traumatic abdominal injury were identified from our health records database. Data were collected regarding FAST utilization, CT scan utilization and timing, need for definitive management, disposition, and length of stay (LOS). Results: 285 patients were included, 152 (53.3%) received a FAST examination, with 33 (22%) having a direct impact on clinical management. CT was performed in 112 (73.6%) of the FAST group, with mean time to imaging of 147.4 minutes, time to trauma team assessment of 21.5 minutes, and ED-LOS of 8.6 hours. In the non-FAST group, 33 (24.8%) received a CT, with time to imaging of 133 minutes, time to trauma team assessment of 133 minutes, and ED-LOS of 13.8 hours. 75.6% of the FAST group required admission and 9.2% required definitive management; admission was needed for 38.3% of the non-FAST group and 2.2% required definitive management. Conclusion: This is the first study to assess patient outcomes with respect to FAST in the era of early whole body CT in trauma. Although FAST does not directly impact care for the majority of blunt trauma patients, it demonstrates usefulness in some patients by directing CT utilization and expediting disposition from the ED.

Repairing the injured bronchus in blunt chest trauma – A case series

Trauma ◽  
2021 ◽  
pp. 146040862098811
Author(s):  
Anith Nadzira Riduan ◽  
Narasimman Sathiamurthy ◽  
Benedict Dharmaraj ◽  
Diong Nguk Chai ◽  
Narendran Balasubbiah
Keyword(s):  
Blunt Trauma ◽  
Chest Trauma ◽  
Surgical Intervention ◽  
Case Series ◽  
Trauma Patients ◽  
Lung Collapse ◽  
Comprehensive Management ◽  
Lung Capacity ◽  
Management Algorithm ◽  
Operative Outcomes

Introduction Traumatic bronchial injury (TBI) is uncommon, difficult to diagnose and often missed. The incidence of TBI among blunt trauma patients is estimated to be around 0.5–2%. Bronchoplastic surgery is indicated in most cases to repair the tracheobronchial airway and preserve lung capacity. There is limited existing literature addressing the management of this condition in view of its rarity. The comprehensive management and outcomes of these patients are discussed. Methods The case notes of all patients who presented with persistent lung collapse due to trauma since July 2017 were reviewed retrospectively. Those patients requiring surgical intervention were included in the review. The mode of injury, clinical, radiological and bronchoscopy findings, concurrent injuries, type of surgery, length of stay (LOS) and operative outcomes were reviewed. Results Out of 11 patients who presented with persistent lung collapse post-blunt trauma, four (36%) were found to have structural bronchial disruption. All of them underwent successful repair of the injured bronchus, without the need of a pneumonectomy. The other seven patients were successfully treated conservatively. Conclusion The repair of the injured bronchus is essential in improving respiratory function and to prevent a pneumonectomy. Routine bronchoscopic evaluation should be performed for all suspected airway injuries as recommended in our management algorithm. Delayed presentations should not hinder urgent referral to thoracic centers for tracheobronchial reconstruction.

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