How to Assess a Rib Fracture

Suspect a rib fracture anytime a person receives a blow to the chest and feels a great deal of pain at the point injured. Look for the following signs as indicators of the severity of the injury.

Instructions

Simple Rib Fracture

1. Gently touch the area of the chest that received the blow. The injured person will complain of sharp tenderness at the point of the fracture if one or more ribs were broken.

2. Have the injured person take a deep breath or cough: Does he or she feel sharp, stabbing pain? If yes, suspect a fractured rib.

3. Look for the following additional signs and symptoms: deformity or discoloration around the chest area; shallow breathing to minimize the pain with each breath; an elevated respiratory rate. The presence of any of these signs may indicate a fractured rib.

4. Decrease movement on the side of the fracture using one of the following methods: Tape the factured side with four or five pieces of adhesive tape from the sternum to the spine; apply an elastic bandage around the entire chest; use a sling and swathe to immobilize the arm against the injured side; tape a stuff sack filled with clothes loosely to the injured side of the chest. See "How to Treat a Rib Fracture."

5. Administer ibuprofen, acetaminophen or naproxen sodium for pain.

6. Encourage the injured person to cough frequently, despite the pain, in order to prevent secretions from pooling in the lung causing pneumonia.

7. Evacuate immediately, monitoring for difficulty breathing. The injured person may be able to walk out if there are no signs of respiratory distress.

Serious Fractures and Flail Chest

1. Look for the signs of respiratory distress immediately after a major impact to the chest: rapid and shallow breathing; elevated heart rate; a bluish tint around the nose and mouth; no detectable breathing.

2. Look for the signs of a punctured lung: increased difficulty breathing; coughing up blood.

3. Place one hand on each side of the injured person's chest and observe the way in which the chest moves with inhalations. If one side of the chest rises during inhalation while the other falls, at least three ribs have been broken on the falling side of the chest.

4. Treat immediately if the person appears to have punctured a lung or has multiple fractures. The best treatment is to roll the person onto the injured side and place a rolled piece of clothing underneath the fractured area to support it.

5. Evacuate immediately, monitoring for respiratory distress. The person will not be able to walk out and must be carried on a backboard or in a litter, or flown out with a helicopter.

Tips & Warnings

• Do not administer narcotics such as codeine for pain. These may interfere with the injured person's ability to breathe.

• Never wrap an adhesive bandage around the entire chest as this will restrict breathing. Only an elastic bandage should be used to tape the entire chest, and breathing should be monitored continually.

• Be especially careful about taping the chest at elevations over 10,000 where breathing is more difficult. Use a sling or a padded stuff sack to restrict movement whenever possible.

• This information is not intended to be a substitute for professional medical advise or treatment.