A multidisciplinary clinical pathway decreases rib fracture–associated infectious morbidity and mortality in high-risk trauma patients

RibScore

“…Adequate pain control minimizes these complications by allowing deep breathing and improved respiratory function. An aggressive rib fracture multidisciplinary clinical pathway focusing efforts on respiratory therapy, pain control, physical therapy, and nutrition services has been shown to decrease mechanical ventilator-dependent days, length of stay, infectious morbidity, and mortality in a prospective observational cohort study, 23 suggesting a benefit to accurate early risk stratification of patients with chest trauma.…”

Chest injuries – what is new?

“…Compared with morphine by patient-controlled analgesia, nebulized morphine provided equivalent pain relief with less sedation. In a prospective cohort study of 150 patients Todd et al [12] compared various parameters with a historic control of 150 patients prior to establishment of a multidisciplinary clinical pathway for treating patients older than 45 years of age with more than four rib fractures. They concluded that incentive spirometry should be established for patients with rib fractures to decrease the incidence of pneumonia, intensive care unit and hospital length of stay, as well as mortality.…”

Assessment and management of rib fracture pain in geriatric population

“…A sudden decrease in the performances could be used as a warning of pulmonary deterioration. [2] Ability to cough Strong or weak cough can be a reasonable indicator of respiratory effort [15].…”