Rib fracture - Revision history

Azhandos: /* Admission */

2024-10-30T02:13:16Z

Admission

← Revisión anterior		Revisión del 02:13 30 oct 2024
Línea 52:		Línea 52:

	===Admission===		===Admission===
			*≥ 65 years of age
			*3-5 uncomplicated rib fractures
			*RR > 18/min despite adequate pain control
			*Incentive spirometry < 75% of predicted
			*Unable to control pain with oral medications

	*Consider for:		*Consider for:
	**Elderly patient with multiple rib fractures, hypotension, pulmonary contusion, hemothorax, pneumothorax, or age >85<ref>Lotfipour S, Kaku SK, Vaca FE, Patel C, Anderson CL, Ahmed SS. Factors associated with complications in older adults with isolated blunt chest trauma. West J Emerg Med. 2009 May. 10(2):79-84.</ref>		**Elderly patient with multiple rib fractures, hypotension, pulmonary contusion, hemothorax, pneumothorax, or age >85<ref>Lotfipour S, Kaku SK, Vaca FE, Patel C, Anderson CL, Ahmed SS. Factors associated with complications in older adults with isolated blunt chest trauma. West J Emerg Med. 2009 May. 10(2):79-84.</ref>
Línea 57:		Línea 63:
	**Significant associated injury		**Significant associated injury
	**Pre-existing pulmonary disease		**Pre-existing pulmonary disease

			===ICU===
			*Severe rib fractures (e.g., > 5 ribs, multiple displaced fractures, flail chest)
			*Signs of significant respiratory compromise (e.g., SpO2 < 92%)
			*Risk of respiratory decompensation (e.g., older age, COPD, neuromuscular disease)
			*Discretion of clinician managing patient

	==See Also==		==See Also==

Rossdonaldson1: /* Evaluation */

2021-04-10T13:17:40Z

Evaluation

← Revisión anterior		Revisión del 13:17 10 abr 2021
Línea 22:		Línea 22:
	[[File:X-ray of rib fractures and pneumothorax.jpg\|thumb\|Right sided [[pneumothorax]] with multiple rib fractures.]]		[[File:X-ray of rib fractures and pneumothorax.jpg\|thumb\|Right sided [[pneumothorax]] with multiple rib fractures.]]
	[[File:BrokenRidCTParaSag.png\|thumb\|Two broken ribs as seen on parasagittal CT.]]		[[File:BrokenRidCTParaSag.png\|thumb\|Two broken ribs as seen on parasagittal CT.]]
			[[File:PMC3259405 13244 2011 72 Fig22 HTML.png\|thumb\|Coronal CT image showing multiple contiguous left rib fractures (arrows).]]
	===Workup===		===Workup===
	''Rib series typically <u>not</u> indicated''		''Rib series typically <u>not</u> indicated''

Rossdonaldson1: /* Background */

2021-04-08T19:56:28Z

Background

← Revisión anterior		Revisión del 19:56 8 abr 2021
Línea 1:		Línea 1:
	==Background==		==Background==
			[[File:Gray530.png\|thumb\|Left pleura cavity (viewed from left) showing intercostal bundles (vein, artery, and nerve) under ribs.]]
	*Most common injury in blunt chest trauma		*Most common injury in blunt chest trauma
	*9th, 10th, 11th rib fractures associated with intra-abdominal injury		*9th, 10th, 11th rib fractures associated with intra-abdominal injury

Rossdonaldson1: /* Evaluation */

2021-04-08T16:19:42Z

Evaluation

← Revisión anterior		Revisión del 16:19 8 abr 2021
Línea 19:		Línea 19:
	[[File:multipleribfractures.png\|thumbnail\|Multiple right-sided acute rib (and clavicle) fractures.]]		[[File:multipleribfractures.png\|thumbnail\|Multiple right-sided acute rib (and clavicle) fractures.]]
	[[File:Fracturedribsmarked.jpg\|thumb\|[[CXR]] with multiple old/healed fractured ribs of the person's left side (oval).]]		[[File:Fracturedribsmarked.jpg\|thumb\|[[CXR]] with multiple old/healed fractured ribs of the person's left side (oval).]]
			[[File:X-ray of rib fractures and pneumothorax.jpg\|thumb\|Right sided [[pneumothorax]] with multiple rib fractures.]]
	[[File:BrokenRidCTParaSag.png\|thumb\|Two broken ribs as seen on parasagittal CT.]]		[[File:BrokenRidCTParaSag.png\|thumb\|Two broken ribs as seen on parasagittal CT.]]
	===Workup===		===Workup===

Rossdonaldson1: /* Evaluation */

2021-04-08T16:17:22Z

Evaluation

← Revisión anterior		Revisión del 16:17 8 abr 2021
Línea 19:		Línea 19:
	[[File:multipleribfractures.png\|thumbnail\|Multiple right-sided acute rib (and clavicle) fractures.]]		[[File:multipleribfractures.png\|thumbnail\|Multiple right-sided acute rib (and clavicle) fractures.]]
	[[File:Fracturedribsmarked.jpg\|thumb\|[[CXR]] with multiple old/healed fractured ribs of the person's left side (oval).]]		[[File:Fracturedribsmarked.jpg\|thumb\|[[CXR]] with multiple old/healed fractured ribs of the person's left side (oval).]]
			[[File:BrokenRidCTParaSag.png\|thumb\|Two broken ribs as seen on parasagittal CT.]]
	===Workup===		===Workup===
	''Rib series typically <u>not</u> indicated''		''Rib series typically <u>not</u> indicated''

Rossdonaldson1: /* Evaluation */

2021-04-08T16:16:45Z

Evaluation

← Revisión anterior		Revisión del 16:16 8 abr 2021
Línea 18:		Línea 18:
	[[File:Ribs labeled.png\|thumb\|Ribs labled on [[CXR]].]]		[[File:Ribs labeled.png\|thumb\|Ribs labled on [[CXR]].]]
	[[File:multipleribfractures.png\|thumbnail\|Multiple right-sided acute rib (and clavicle) fractures.]]		[[File:multipleribfractures.png\|thumbnail\|Multiple right-sided acute rib (and clavicle) fractures.]]
	[[File:Fracturedribsmarked.jpg\|thumb\|[[CXR] with multiple old/healed fractured ribs of the person's left side (oval).]]		[[File:Fracturedribsmarked.jpg\|thumb\|[[CXR]] with multiple old/healed fractured ribs of the person's left side (oval).]]
	===Workup===		===Workup===
	''Rib series typically <u>not</u> indicated''		''Rib series typically <u>not</u> indicated''

Rossdonaldson1: /* Evaluation */

2021-04-08T16:15:46Z

Evaluation

← Revisión anterior		Revisión del 16:15 8 abr 2021
Línea 17:		Línea 17:
	==Evaluation==		==Evaluation==
	[[File:Ribs labeled.png\|thumb\|Ribs labled on [[CXR]].]]		[[File:Ribs labeled.png\|thumb\|Ribs labled on [[CXR]].]]
	[[File:multipleribfractures.png\|thumbnail\|Multiple right sided rib ~~acute~~ fractures.]]		[[File:multipleribfractures.png\|thumbnail\|Multiple right-sided acute rib (and clavicle) fractures.]]
	[[File:Fracturedribsmarked.jpg\|thumb\|[~~{cxr]~~] with multiple old/healed fractured ribs of the person's left side (oval).]]		[[File:Fracturedribsmarked.jpg\|thumb\|[[CXR] with multiple old/healed fractured ribs of the person's left side (oval).]]
	===Workup===		===Workup===
	''Rib series typically <u>not</u> indicated''		''Rib series typically <u>not</u> indicated''

Rossdonaldson1: /* Evaluation */

2021-04-08T16:14:39Z

Evaluation

← Revisión anterior		Revisión del 16:14 8 abr 2021
Línea 17:		Línea 17:
	==Evaluation==		==Evaluation==
	[[File:Ribs labeled.png\|thumb\|Ribs labled on [[CXR]].]]		[[File:Ribs labeled.png\|thumb\|Ribs labled on [[CXR]].]]
			[[File:multipleribfractures.png\|thumbnail\|Multiple right sided rib acute fractures.]]
	[[File:Fracturedribsmarked.jpg\|thumb\|[{cxr]] with multiple old/healed fractured ribs of the person's left side (oval).]]		[[File:Fracturedribsmarked.jpg\|thumb\|[{cxr]] with multiple old/healed fractured ribs of the person's left side (oval).]]
	~~[[File:multipleribfractures.png\|thumbnail\|Multiple right sided rib acute fractures.]]~~
	===Workup===		===Workup===
	''Rib series typically <u>not</u> indicated''		''Rib series typically <u>not</u> indicated''

Rossdonaldson1: /* Evaluation */

2021-04-08T16:14:18Z

Evaluation

← Revisión anterior		Revisión del 16:14 8 abr 2021
Línea 17:		Línea 17:
	==Evaluation==		==Evaluation==
	[[File:Ribs labeled.png\|thumb\|Ribs labled on [[CXR]].]]		[[File:Ribs labeled.png\|thumb\|Ribs labled on [[CXR]].]]
	[[File:multipleribfractures.png\|thumbnail\|Multiple ~~Right~~ sided rib fractures]]		[[File:Fracturedribsmarked.jpg\|thumb\|[{cxr]] with multiple old/healed fractured ribs of the person's left side (oval).]]
			[[File:multipleribfractures.png\|thumbnail\|Multiple right sided rib acute fractures.]]
	===Workup===		===Workup===
	''Rib series typically <u>not</u> indicated''		''Rib series typically <u>not</u> indicated''

Rossdonaldson1 at 16:08, 8 April 2021

2021-04-08T16:08:21Z

← Revisión anterior		Revisión del 16:08 8 abr 2021
Línea 1:		Línea 1:
	==Background==		==Background==
	~~[[File:multipleribfractures.png\|thumbnail\|Multiple Right sided rib fractures]]~~

	*Most common injury in blunt chest trauma		*Most common injury in blunt chest trauma
	*9th, 10th, 11th rib fractures associated with intra-abdominal injury		*9th, 10th, 11th rib fractures associated with intra-abdominal injury
Línea 18:		Línea 16:

	==Evaluation==		==Evaluation==
			[[File:Ribs labeled.png\|thumb\|Ribs labled on [[CXR]].]]
			[[File:multipleribfractures.png\|thumbnail\|Multiple Right sided rib fractures]]
	===Workup===		===Workup===
	''Rib series typically <u>not</u> indicated''		''Rib series typically <u>not</u> indicated''

← Revisión anterior		Revisión del 16:19 8 abr 2021
Línea 19:		Línea 19:
	[[File:multipleribfractures.png\|thumbnail\|Multiple right-sided acute rib (and clavicle) fractures.]]		[[File:multipleribfractures.png\|thumbnail\|Multiple right-sided acute rib (and clavicle) fractures.]]
	[[File:Fracturedribsmarked.jpg\|thumb\|[[CXR]] with multiple old/healed fractured ribs of the person's left side (oval).]]		[[File:Fracturedribsmarked.jpg\|thumb\|[[CXR]] with multiple old/healed fractured ribs of the person's left side (oval).]]
			[[File:X-ray of rib fractures and pneumothorax.jpg\|thumb\|Right sided [[pneumothorax]] with multiple rib fractures.]]
	[[File:BrokenRidCTParaSag.png\|thumb\|Two broken ribs as seen on parasagittal CT.]]		[[File:BrokenRidCTParaSag.png\|thumb\|Two broken ribs as seen on parasagittal CT.]]
	===Workup===		===Workup===