Big T Trauma Series Ep. 10 - Rib Fractures
Behind The Knife: The Surgery Podcast
Behind The Knife: The Surgery Podcast
4.8 • 1.4K Ratings
🗓️ 18 May 2020
⏱️ 39 minutes
🔗️ Recording | iTunes | RSS
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Summary
Hosts: Patrick Georgoff, MD and Jayne McCauley, MD
This…episode….covers…rib…fractures…sorry, I am splinting. Was that a fever? Am I developing pneumonia?! Could this have been avoided with regional anesthesia? Or surgical fixation? Tune in to find out everything you need to know about the management of rib fractures.
References:
- Kasotakis G, Hasenboehler EA, Streib EW, et al. Operative fixation of rib fractures after blunt trauma: A practice management guideline from the Eastern Association for the Surgery of Trauma. J Trauma Acute Care Surg 2017; 82:618.
- Carver TW, Milia DJ, Somberg C, et al. Vital capacity helps predict pulmonary complications after rib fractures. J Trauma Acute Care Surg. 2015 Sep;79(3):413-6.
- Galvagno SM Jr, Smith CE, Varon AJ, et al. Pain management for blunt thoracic trauma: A joint practice management guideline from the Eastern Association for the Surgery of Trauma and Trauma Anesthesiology Society. J Trauma Acute Care Surg. 2016 Nov;81(5):936-951.
- Cheema FA, Chao E, Buchsbaum J, et al. State of Rib Fracture Care: A NTDB Review of Analgesic Management and Surgical Stabilization. Am Surg. 2019 May 1;85(5):474-478.
- Pieracci FM, Leasia K, Bauman Z, et al. A multicenter, prospective, controlled clinical trial of surgical stabilization of rib fractures in patients with severe, nonflail fracture patterns (Chest Wall Injury Society NONFLAIL). J Trauma Acute Care Surg. 2020;88(2):249.
- Pieracci FM, Coleman J, Ali-Osman F, et al. A multicenter evaluation of the optimal timing of surgical stabilization of rib fractures. J Trauma Acute Care Surg. 2018;84(1):1.
Transcript
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| 0:00.0 | Behind the knife, the Surgery Podcast, where we take a behind the scenes intimate look at surgery |
| 0:06.0 | from leaders in the Knife. In this series we cover clinically |
| 0:26.6 | oriented material that focuses on how best to care for the dramatically injured and |
| 0:31.6 | critically ill patient. |
| 0:33.0 | My name is Patrick Georgeoff. |
| 0:34.0 | I'm a Trauma Surgery Fellow at the University of Texas Memorial Hermann, Red Duke Trauma Institute |
| 0:39.0 | in Houston, Texas. |
| 0:40.0 | And today I'm joined by Dr. Jane McCaulay, also a trauma surgery |
| 0:44.4 | to file at the University of Texas in Houston. And today we're going to cover |
| 0:48.7 | rib fractures. And before we do so I want to thank Dr. John Harvin and Dr David Meyer for taking the time out of their busy schedules |
| 0:55.7 | to review this episode and make sure Jane and I aren't saying anything goofy. So Jane, thanks for being here. Why is it important that we talk about rib fractures? |
| 1:04.0 | Thanks for having you back, Patrick. |
| 1:06.3 | Yeah, so rib fractures are common |
| 1:09.1 | and they present in at least 10% of all trauma patients and approximately 30% of patients with chest trauma specifically. |
| 1:16.2 | Right and refractures cause all sorts of problems correct? Oh yeah so that's definitely correct. |
| 1:21.1 | One of the main things we worry about is respiratory function |
| 1:24.8 | which rib fractures can definitely compromise. Right. Rib fractures are very |
| 1:29.2 | painful and this leads to splinting and other issues with pulmonary mechanics. |
| 1:33.4 | Yeah, sure. So a splinting occurs when somebody's ability to breathe is limited by pain. |
| 1:40.6 | And so they ultimately take small breaths. |
| 1:43.6 | Right, and this can easily be observed. |
| 1:45.1 | If you ask the patient take a deep breath, |
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