Abstract Background Patients with isolated rib fractures after blunt chest trauma have significant analgesia requirements. We analysed these requirements and surveyed clinician confidence to inform the need for a chest trauma pathway at our centre over three months. Methods A single-centre, retrospective observational study was conducted. Adult General Surgery patients discharged following an admission with isolated rib fractures after blunt chest trauma were identified between October and December 2023. Electronic records were reviewed to determine length of stay (LoS), analgesia requirements, and STUMBL score (with greater than 16 meaning 52% risk of complications). Additionally, clinicians were surveyed to assess confidence in managing analgesia requirements in this cohort. Results 29 patients were included; average age was 69. Mean LoS was 7.3 days (SD =8.35) and 79.3% of patients had a STUMBL score over 16. Nine (31%) patients, with a mean STUMBL score of 26.4, required regional anaesthesia for effective pain control which was associated with a significantly increased LoS (15.1 days, p=0.0304). 51.3% required analgesia escalation after initial clerking prescription. 42 clinicians answered a questionnaire. Clinicians averaged 3/5 in confidence in managing analgesia requirements. 33 (79%) clinicians do not use any risk stratification tools and 37 (88%) would find a local chest trauma tool helpful. Conclusions Over three quarters of our patient cohort had a high risk of complications and those requiring regional anaesthesia had a longer LoS. A local chest trauma pathway could improve clinician prescribing confidence and provide adequate analgesia from the point of initial clerking and reduce LoS.
Leong et al. (Fri,) studied this question.
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