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Beard L, Holt B, Snelson C, et al. Analgesia of Patients with Multiple Rib Fractures in Critical Care: A Survey of Healthcare Professionals in the UK. Indian J Crit Care Med. 2020;24(3):184-189doi: 10.5005/jp-journals-10071-23375.
Beard, L., Holt, B., Snelson, C., Parcha, C., Smith, F. G., & Veenith, T. (2020). Analgesia of Patients with Multiple Rib Fractures in Critical Care: A Survey of Healthcare Professionals in the UK. Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine, 24(3), 184-189. https://doi.org/10.5005/jp-journals-10071-23375
Beard, Laura, et al. "Analgesia of Patients with Multiple Rib Fractures in Critical Care: A Survey of Healthcare Professionals in the UK." Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine vol. 24,3 (2020): 184-189. doi: https://doi.org/10.5005/jp-journals-10071-23375
Beard L, Holt B, Snelson C, Parcha C, Smith FG, Veenith T. Analgesia of Patients with Multiple Rib Fractures in Critical Care: A Survey of Healthcare Professionals in the UK. Indian J Crit Care Med. 2020 Mar;24(3):184-189. doi: 10.5005/jp-journals-10071-23375. PMID: 32435097; PMCID: PMC7225763.
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Indian J Crit Care Med. 2020 Mar;24(3):184-189. doi: 10.5005/jp-journals-10071-23375.

Analgesia of Patients with Multiple Rib Fractures in Critical Care: A Survey of Healthcare Professionals in the UK.

Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine

Laura Beard, Billy Holt, Catherine Snelson, Chetan Parcha, Fang Gao Smith, Tonny Veenith

Affiliations

  1. Department of Anesthesia and Critical Care, Queen Elizabeth Hospital Birmingham, Birmingham, UK.
  2. Department of Anesthesia and Critical Care, Leeds Teaching Hospitals NHS Trust, Leeds, UK.
  3. Birmingham Acute Care Research Group, University of Birmingham, Birmingham, UK.

PMID: 32435097 PMCID: PMC7225763 DOI: 10.5005/jp-journals-10071-23375

Abstract

INTRODUCTION: Good analgesia has been shown to reduce the risk of pneumonia, chronic pain, and mortality in patients with multiple rib fractures (MRFs). This survey explores the current analgesic practice in the UK, protocol use, barriers to provision, and physician preferences.

MATERIALS AND METHODS: A web-based survey was distributed nationally to an enriched cohort of clinicians working in UK trauma units with an interest in MRF management.

RESULTS: Seventy-nine healthcare professionals responded. A third (31.4%) reported that their department had a rib fracture pain protocol, 52.9% did not, and 15.7% were unsure. Significantly more respondents reported adequate pain control when a hospital protocol was present compared to when not (

DISCUSSION: There is considerable variation among physicians in their current use of analgesic modalities, with opiate-based methods predominating despite a physician preference for regional techniques. Thoracic epidurals are preferred by physicians but of limited use as a result of contraindications, time pressures, and staff skill mix. Pain control is reported to be better handled when protocols are present. Further research focusing on currently utilized regional techniques is required in order to produce a validated standardized national protocol that is informed by the current practice, the evidence base, and limitations to service provision.

KEY MESSAGES: There is considerable variation among physicians in their current use of analgesic modalities. Opiate-based methods dominate for thoracic trauma despite a physician preference for regional techniques, which can be challenging in this cohort due to contraindications, staff skill mix, and time pressures. Inadequate analgesia is common but is better managed when pain management protocols are available.

HOW TO CITE THIS ARTICLE: Beard L, Holt B, Snelson C, Parcha C, Smith FG, Veenith T. Analgesia of Patients with Multiple Rib Fractures in Critical Care: A Survey of Healthcare Professionals in the UK. Indian J Crit Care Med 2020;24(3):184-189.

Copyright © 2020; Jaypee Brothers Medical Publishers (P) Ltd.

Keywords: Analgesia; Critical care; Pain relief; Rib fractures; Thorax trauma

Conflict of interest statement

Source of support: Fang Gao Smith is supported by the NIHR Senior Investigator Award. Tonny Veenith is supported by NIHR, Clinical Research Network and the NIAA. Laura Beard has had conference travel

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