Rib Fractures

Rib Fractures
In most cases, a simple, isolated rib fracture elicits sharp, knife-like pain, and respiratory distress; however, as the patient relaxes and begins to breathe with their diaphragm, the respiratory distress subsides. Depending on the location of the fracture and it's severity, if there are multiple rib fractures especially to the same rib or ribs (flail chest), the patient may present with or develop respiratory distress due to lung damage and/or internal bleeding.

Isolated Rib Fracture S/Sx

• Sharp knife-like pain on inspiration that resolves with abdominal breathing.
• Lung damage and/or internal bleeding are possible.

Isolated Rib Fracture Treatment

• Position patient in position of comfort. Reassure & coach abdominal breathing.
• Begin a Level 3 EVAC. Depending on pain, patients may be able to self-evac; minimize patient’s work load (no/light pack). Do not bind patient’s ribs; instead, encourage them to take a deep breath every 20 minutes; both help prevent a secondary pneumonia.
• Begin an urgent, level 1 evacuation if lung damage and/or volume shock is suspected.

Multiple Rib Fractures S/Sx

• Sharp knife-like pain on inspiration that is usually not relieved by abdominal breathing; lung damage and/or internal bleeding are likely.

Multiple Rib Fractures Treatment

• Position patient in position of comfort: sitting if awake; lying on injured side if voice-responsive, pain-responsive, or unresponsive.
• Reassure & coach patient to abdominal breathe. Do not bind the patient’s ribs; instead, encourage them to take a deep breath every 20 minutes; both help prevent a secondary pneumonia.
• Begin an urgent, level 1 evacuation if lung damage and/or volume shock is suspected.

Interested in anticipating and preventing potential problems in the outdoors? Want to be able to take  care of your family or friends should something unexpected happen? Take one of our wilderness medicine courses. Guides and expedition leaders should consider taking our Wilderness First Responder course.
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