Rib fracture

  • Management
    • First-line (Pain Control - Critical): c
      • Mild-moderate pain: Oral NSAIDs, acetaminophen, +/- oral opioids.
      • Severe pain: IV opioids or Patient-Controlled Analgesia (PCA).
      • Incentive Spirometry & Pulmonary Hygiene: Mandatory to prevent splinting, atelectasis, and pneumonia.
    • Second-line (Refractory Pain/Hypoventilation): Intercostal nerve block or thoracic epidural anesthesia.
    • Surgical Stabilization: Reserved for flail chest with failure to wean from mechanical ventilation, or severe chest wall deformity.
    • Contraindicated: Rib belts, binders, or taping (restricts chest expansion and increases atelectasis/pneumonia risk).