265 Assessing Management of Rib Fractures in the ICU Patient. (28th February 2022) - Kenny, L.
Abstract: Aim: Assess if the General Intensive Care Unit (ICU) are appropriately following trust guidelines on rib fracture management. Method: Data gathered from patients admitted to the General Intensive Care Unit between March and May 2021 with any diagnosis code involving rib fracture (n = 19). Exclusions: patients not admitted to general ICU, or who died before being extubated. Of the remaining patients (n = 14) data gathered on: whether they had regular simple analgesia +/- strong analgesia +/- lidocaine plasters. where they met criteria for epidural/block, whether they were referred for this. where they met criteria for rib fixation, whether they were referred & if this occurred. complication rate (i.e., lower respiratory tract infection (LRTI)). Results: All patients were prescribed regular simple analgesia. Most patients were prescribed strong analgesia (n = 10) and lidocaine patches (n = 13). All patients had regular pain assessments. 9 patients were referred for a block/epidural, out of 12 who met criteria for referral. 10 patients were referred for rib fixation, and 4 patients had rib fixation, out of 11 who met criteria for referral. 6 patients developed a LRTI post rib fracture. Conclusions: The basic management of rib fractures in General ICU is appropriate; 100% of patients had analgesia prescribed and had regular assessments of pain. However, some patients who met criteria for consideration of a block (n = 3) or fixation (n = 1) did not have documentation that they were referred. Rib fractures often do not occur in isolation, and it may be that other injuries served as distractors.