32 hours ago Dr. Heidi Fowler answered: "It is essential: To be compliant with your physician's medical recommendations." U.S. doctors online now Ask doctors free. A 43-year-old member asked: I have a broken rib in the care of the hospital., what to do? 1 … >> Go To The Portal
You would need hospitalization if there is any associated findings ( collapsed lung, etc). One rib fracture does not need treated unless it is significantly displaced (rare with one rib fracture ), or endangering the heart or large blood vessels. Ask U.S. doctors your own question and get educational, text answers — it's anonymous and free!
Older adults who get rib fractures have longer hospital stays as a result of the injury and are at higher risk for complications like respiratory failure and pneumonia, according to emergency medicine expert Dr. Christina L. Shenvi, who wrote about the topic in a post for Academic Life in Emergency Medicine.
" Yale New Haven Hospital’s Level 1 Trauma Center provides 24/7 access to a team of different specialists,” says Adrian Maung, MD, a Yale Medicine trauma surgeon. “If you suspect your fracture is serious, or you’re not sure, the best advice is to go to the trauma center immediately.” What are the most common causes of rib fracture?
A doctor can assess the severity of your rib fracture by performing a physical examination and by looking at a chest X-ray. If you have a complex injury, the or she may want to order further testing such as a CT scan to help diagnose any related injuries.
Conclusion: The majority of patients admitted to the hospital with multiple rib fractures can be discharged within three days.
Healing takes at least 6 weeks. If you injure other body organs, you may need to stay in the hospital. Otherwise, you can heal at home. Most people with broken ribs do not need surgery.
If a person has more than one fractured rib, severe damage, or flail chest, they may need surgery. During the operation, a surgeon will use plates and screws to fasten the broken ribs together. Surgery will also repair any damage to internal organs, nerves, or blood vessels.
In most cases, a fractured rib will heal on its own in about six weeks. Doctors no longer prescribe compression wraps for rib fractures, because they can restrict breathing, leading to pneumonia, or even a partial lung collapse. Pain management is important, especially in the first few days after an injury.
ComplicationsTorn or punctured aorta. A sharp end of a break in one of the first three ribs at the top of your rib cage could rupture your aorta or another major blood vessel.Punctured lung. The jagged end of a broken middle rib can puncture a lung and cause it to collapse.Lacerated spleen, liver or kidneys.
Because ribs help you expand your chest to breathe, when you have a break, it is very painful to breath or cough. Not fully inflating your lungs allows the far ends of the lungs to collapse. This makes you more susceptible to developing pneumonia.
In the past, doctors recommended taping or wrapping broken ribs. This is no longer done because taping makes it hard for you to take deep breaths. Taking deep breaths may help prevent pneumonia or a partial collapse of a lung. Your rib will heal in about 6 weeks.
The middle ribs are most commonly fractured. Fractures of the first or second ribs are more likely to be associated with complications.
Although painful, most simple rib fractures do not require surgery but instead time, rest and physical therapy can help with healing and maintaining range of motion.
When untreated, rib fractures will lead to serious short-term consequences such as severe pain when breathing, pneumonia and, rarely, death. Long-term consequences include chest wall deformity, chronic pain and decreased lung function.
It's surprisingly easy to break a rib doing something as simple as swinging a golf club. If you have osteoporosis or lesions from cancer, you may be at a higher risk for broken ribs. You may also have a cracked rib that isn't as dangerous as a broken rib but can still be painful.
The key to rib fracture treatment is pain control, breathing exercises to maintain the lungs fully inflated, and physical therapy. Because the risk of complications increases with age, older patients may require hospitalization, sometimes in an intensive care unit.
Due to variations in older adults' vigor prior to fracture, a robust 70-year-old with four rib fractures may fare well post-injury, while a 60-year-old with two rib fractures and multiple comorbidities may need transfer to a Level I Trauma Center.
A variety of factors contribute to rib fracture risk in older adults, such as polypharmacy, chronic health conditions, frailty, increased proneness to dehydration and decreased self-awareness.
When patients sustain a rib fracture, pain may preclude normal breathing or secretion clearing. To avoid intensifying discomfort, patients' breathing becomes shallower and they repress coughing, leading to respiratory insufficiency. "You can imagine a set of broken ribs on top of a cough," says Dr. Kim. "Coughing hurts."
Helping elderly patients with rib fractures avoid serious respiratory complications. Motor vehicle, motorcycle and snowmobile accidents cause rib fractures in the elderly population, but far and away the biggest mechanism of injury for rib fracture in older adults involves falls from standing height or from ladders or step stools.
Imaging. Simple chest X-ray is an ad junct for use in trauma evaluation. However, if a patient meets criteria for transfer to a Level I Trauma Center, advanced imaging, such as a CT scan, is not required — the patient should simply be prepared for transfer.
Dr. Kim explains that in many ways, managing trauma- related rib fracture in an el derly patient — and thus averting respiratory complications such as pneumonia — is more art than science. In other words, individualization and tailoring of care are critical for geriatric patients with this injury.
Patients with rib fractures are at risk for pneumonia because of low tidal volumes as chest wall excursion is limited by pain and pneumonia is associated with higher mortality. By effectively reducing pain, rates of pneumonia and mortality may be reduced. Several studies have looked at epidural analgesia compared with IV pain medications. It was hoped that epidural analgesia would provide superior pain control and reduce rates of pneumonia. For example, in one randomized controlled trial patients with blunt chest trauma were assigned to either epidural or IV analgesia . They found rates of pneumonia were 18% and 38% in the epidural and IV opioid groups respectively (adjusted OR of 6.0, p=0.05). The patients with epidural analgesia also had half as many days on the vent (p<0.001).
When evaluating a patient for possible discharge or admission after blunt trauma, you need to know which patients are at highest risk of pneumonia and death. A recent systematic review and meta-analysis sought to identify the factors that contribute to mortality after blunt chest trauma . They found the following:
Many of the earlier studies of mortality and rib fractures relied on CXR alone to diagnose the fractures. CXRs pick up some of the more severe fractures, but screening CXRs can miss up to 50% of rib fractures . As more and more patients are imaged with CTs, the mortality of rib fractures may appear to fall, since more subtle fractures are picked up. CT has the advantage of being able to better define whether there is parenchymal injury, and identify other intra-thoracic injuries, but may not add much over CXR in terms of prognostication :
While many patients with rib fractures can be discharged home with oral analgesics and an incentive spirometer, certain patients are at much higher risk for morbidity and mortality. This post will look at which patients are at risk, what factors predict increased mortality, and inpatient interventions that can reduce mortality, ...
In older adults with blunt chest trauma, have a low threshold for admission for patients with multiple fractures to optimize analgesia and pulmonary therapy. The data currently does not clearly support an advantage of epidural analgesia compared with IV opioids.
Broken or fractured ribs are a common injury typically caused by chest trauma, such as a fall, a car accident, or impact sustained during contact sports, according to the Mayo Clinic. Many "broken" ribs are actually cracked, which makes them less dangerous than ribs that actually break into separate pieces.
In the latter case, the b roken bone's edges can injure major blood vessels or organs, including the lungs, spleen, liver, or kidneys. Those who break three or more adjacent ribs can also develop a serious condition called flail chest, in which the broken part of the chest can't hold its shape.
Supreme Court Justice Ruth Bader Ginsburg fell in her office and broke three ribs Wednesday night, according to a statement from the court's public information office. Though the 85-year-old went home after the fall, she has since been admitted to George Washington University Hospital, after experiencing "extreme discomfort overnight.".
muratart/Shutterstock. Rib fractures are among the most common bone breaks in older adults, according to the Mayo Clinic's Health Letter.
Most of the time, fractured ribs heal on their own over the course of six weeks. During that time, patients with broken ribs can take pain-relieving medications.
They may even happen after mild to moderate trauma, such as a fall from standing, according to the Mayo Clinic. "While rib fractures from mild or moderate trauma or repetitive movement may seem less severe, they are still painful and can lead to serious complications," the Mayo Clinic Health Letter said.
Ginsburg said she, "thought it was nothing," and was quickly back at work. "She indeed did not skip a beat and did not feel it rose to a serious health concern," Kathy Arberg, a court public information officer, told Reuters at the time.
No hospital stay: Having experienced several personally, the pain will calm down in 2-3 weeks and take an average of 4-6 weeks to resolve. You will not need hospital stay unless you have injured your lung/have a pneuomothorax, or other trauma.
It is essential: To be compliant with your physician's medical recommendations.