Spectrum Health Rib Fracture Guideline Adult Inpatient Outpatient Instructions

: June 13, 2024
: Spectrum Health

Table of Contents

Clinical algorithm
Clinical guideline summary
Treatment and Management
References
References
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Guideline: Rib Fracture Guideline, Adult,
Inpatient/Outpatient
Updated: September 30, 2021
Clinical Pathways Program

Clinical algorithm

Spectrum Health Rib Fracture Guideline Adult Inpatient
Outpatient

*Review BEERS criteria for patients years Hold anticoagulation if supratherapeutic or anticipating potential anesthesia intervention or surgical fixation

FRAIL Questionnaire Screening Tool
Fatigue: Are you fatigued?
Resistance: Cannot walk up 1 flight of stairs?
Aerobic: Cannot walk 1 block?
Illnesses: Do you have more than 5 illnesses?
Loss of weight: Have you unintentionally lost

5% your weight in last 6 months?
Scoring: Frail > 3 / Pre-Frail: 1 or 2

Plating (Need 3D CT reconstruction with and without scapula)

Flail chest
Multiple, severe (bicortical) displaced fractures
Early failure of no-op management (inadequate pain relief, unable to wean from vent)
IS <750

See Treatment and Management for further follow-up requirements.

Clinical guideline summary

CLINICAL GUIDELINE NAME: Rib Fracture Adult Inpatient/Outpatient
PATIENT POPULATION AND DIAGNOSIS: Patients >18 years old with acute rib fractures <24
hours old or injury >24 hours old and symptomatic
APPLICABLE TO: All Spectrum Health Sites

BRIEF DESCRIPTION: The guideline is intended to summarize the approach to treatment for adult patients with rib fractures. Based on the guideline the patient will be admitted to the optimal location, will be provided multi modal pain control, and aggressive pulmonary hygiene in order to help prevent pneumonia, decrease ICU as well as hospital days.
OVERSIGHT TEAM LEADER(S): Patricia Pentiak
OWNING EXPERT IMPROVEMENT TEAM (EIT): Trauma
MANAGING CLINICAL PRACTICE COUNCIL (CPC): Acute Health CPC
CPC APPROVAL DATE: July 2021
OTHER TEAM(S) IMPACTED: Pharmacy, Radiology, Respiratory
IMPLEMENTATION DATE: n/a
LAST REVISED: September 30, 2021
FOR MORE INFORMATION, CONTACT: Patricia Pentiak

Clinical pathways clinical approach

Treatment and Management

References

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