rib fracture


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rib fracture

a break in a bone of the thoracic skeleton caused by a blow or crushing injury or by violent coughing or sneezing. It may also be a pathological fracture secondary to metastatic disease. The ribs most commonly broken are the fourth to eighth; if the bone is splintered or the fracture is displaced, sharp fragments may pierce the lung, causing hemothorax or pneumothorax.
observations The patient with a fractured rib suffers pain, especially on inspiration, and usually breathes rapidly and shallowly. The site of the break is generally very tender to the touch, and the crackling of bone fragments rubbing together may be heard on auscultation. Breath sounds may be absent, decreased, or accompanied by rales and rhonchi. The location and nature of the fracture are determined by chest x-ray studies. The patient is observed for signs of hemoptysis, hemothorax, flail chest, atelectasis, pneumothorax, and pneumonia.
interventions Fractured ribs may be splinted with an elastic belt or bandage or adhesive strapping. To prevent irritation, the area may be shaved and painted with tincture of benzoin before the adhesive tape is applied. Increasingly, however, no splints are used, because they compromise chest expansion and predispose the patient to pulmonary complications. If hospitalization is required, the patient is placed in a semi-Fowler's position, and the blood pressure, pulse, temperature, respirations, and breath sounds are checked every 2 to 4 hours. An analgesic may be ordered, but morphine sulfate is avoided because it depresses respiration. If strapping and analgesic medication fail to relieve pain, the physician may perform a regional nerve block by infiltrating the intercostal spaces above and below the fracture site with 1% procaine.
nursing considerations The nurse assists in splinting the chest, administers the ordered medication, helps the patient to turn, and instructs the patient in how to perform deep breathing, coughing, and range-of-motion exercises of the extremities.
References in periodicals archive ?
Aguero suffered a major rib fracture after his taxi hit a lamp post in Amsterdam on September 28.
Initially the injured man was transferred to Limassol hospital where he was diagnosed with a fractured skull, a rib fracture and brain haemorrhages.
Formula One is a very unique sport, and with the G-forces that rib fracture could move into the lung as well.
A penetrating injury from a displaced rib fracture or a stab or gunshot wound typically causes a small diaphragmatic puncture [1-3].
Sentinel injuries--designed to flag injuries that are unusual for the child's age--included rib fracture, abdominal trauma, genital injury, or subconjunctival hemorrhage for children under 24 months; femur /humerus fracture, radius/ ulna / tibia/ fibula fracture, isolated skull fracture or intracranial hemorrhage for children under 12 months; and bruising, burns, or oropharyngeal injury for children under 6 months.
COMPLICATION: Major complication were noted in 6 patients (2 multiple rib fracture, 2 pneumothorax, 1 haemothorax, 1 cardiac tamponade).
CT Bone Reading can shorten radiologists' bone reading time by 50% and increase the sensitivity of rib fracture detection by 10%.
10) The purpose of our recent experience is to evaluate epidural analgesia versus intravenous opioid analgesia for rib fracture pain.
The victim had reportedly struck the ground head first, suffering a skull fracture, bleeding from the nose and ear, and a rib fracture.
By contrast, complications such as nonunion and plexus brachialis palsy have been reported in a few cases of first rib fracture (Edwards and Murphy, 2001; Ochi et al.
The singer was later taken to hospital where he was examined for a suspected rib fracture and ligament damage.