Rib Cage Trauma

This includes flail chest, rib fractures, intercostal muscle rupture, and penetrating wounds. Signs mimic pleural space injury (restrictive breathing pattern). Usually the defect is obvious, especially if paradoxical chest wall motion is noted.

- Adequate management usually involves careful handling, laying the patient with affected side down, minimizing restrictive chest bandaging, and providing analgesia. External splinting or surgical management is usually not necessary unless injury is severe or extensive, or the chest wall is compromised and prolonged interference with gas exchange and ventilation is evident.
- Pain can substantially interfere with gas exchange and ventilation. Alleviate pain once the patient is stabilized to improve oxygenation and ventilation. Systemic or local analgesia are acceptable options (See CPG 16). Local nerve/rib blocks and intrapleural analgesia administration work well and are readily accomplished.