SCCM Resource Library-Spare My Ribs: Conservative Management for Severe Chest Wall Injury in Mechanically Ventilated Patients

Spare My Ribs: Conservative Management for Severe Chest Wall Injury in Mechanically Ventilated Patients

Video Transcription

Video Summary

In this video, Dr. Diaz discusses the epidemiology and significance of chest wall injuries, specifically rib fractures, in the United States. He highlights that rib fractures are common, catastrophic, and costly, with 10 to 40% of trauma patients in the US presenting with rib fractures. Rib fractures can lead to morbidity, including pneumonia, and can even be fatal in the presence of flail chest. The current state of non-surgical pain management strategies for mechanically ventilated patients with rib fractures is then described. Dr. Diaz discusses various local regional pain control options, including epidural catheters, paravertebral blocks, serratus anterior blocks, erector spinae blocks, and intercostal nerve blocks. He emphasizes the individualization of pain management approaches for each patient and the importance of having a decision algorithm in place. The use of systemic therapies such as IV lidocaine or ketamine is also discussed, although the data supporting their efficacy in this patient population is limited. Dr. Diaz concludes by highlighting that mechanical problems such as rib fractures require a mechanical fix and that medical therapies are essential but may not be sufficient to address the acute and long-term pain associated with these injuries.

Asset Subtitle

Pulmonary, Procedures, 2023

Asset Caption

Type: one-hour concurrent | To Fix or Not to Fix, That Is the Question: Severe Chest Wall Trauma in the Mechanically Ventilated (SessionID 1228192)

Meta Tag

Content Type Presentation

Knowledge Area Pulmonary

Knowledge Area Procedures

Membership Level Professional

Membership Level Select

Tag Mechanical Ventilation

Year 2023

Keywords

epidemiology

chest wall injuries

rib fractures

morbidity

pain management

mechanical fix

	Society of Critical Care Medicine 500 Midway Drive Mount Prospect, IL 60056 USA Phone: +1 847 827-6888 Fax: +1 847 439-7226 Email: support@sccm.org	Contact Us About SCCM Newsroom Advertising & Sponsorship DONATE	MySCCM LearnICU Patients & Families Surviving Sepsis Campaign Critical Care Societies Collaborative	GET OUR NEWSLETTER
© Society of Critical Care Medicine. All rights reserved. \| Privacy Statement \| Terms & Conditions The Society of Critical Care Medicine, SCCM, and Critical Care Congress are registered trademarks of the Society of Critical Care Medicine.