Ribs Injury

Age: ‍ years old

Gender: ‍malefemale



HISTORY:

Presents with a chest pain following an injury ‍ ‍days ago

Mecanism of injury: ‍ ‍unclear ‍fall ‍twist ‍direct blow ‍penetrating trauma ‍sports injury ‍motor vehicle accident

Location is: ‍

Radiation ‍none to ‍

Rated at ‍012345678910 / 10 ‍

Described as ‍dullaching

Pattern ‍persistentintermittent

Worsening factors: ‍none

Alleviating factors: ‍none, ‍effectiveineffective

Occupation: ‍



Associated symptoms: *Try using right-click for negatives*

‍shortness of breath

‍cough, ‍non-productiveproductive of ‍clearcolored phlegm

‍sputum production, ‍clearwhiteyellowgreen

‍nausea

‍vomiting, ‍ episodes ‍per day, ‍, ‍hematemesis

‍diaphoresis

‍palpitations

‍dizziness

‍syncope



Contributing factors:

‍smoking

no history of: ‍osteoporosis, ‍PTX, ‍pulmonary embolism

no use of: ‍anticoagulants





EXAM:

General appearance: ‍well-appearing, ‍apparent distress

Vital signs: ‍normal, BP ‍, HR ‍, RR ‍, SpO2 ‍ %, Temp ‍°

Neck: ‍normal, ‍lymphadenopathy, ‍, c-spine ‍

Heart: ‍RRR, ‍MRG, ‍normal S1 and S2

Lungs: ‍clear bilaterally, ‍abnormal sounds, ‍retractions

Chest: ‍tenderness on ‍rightleft ‍

Breasts: ‍normal, ‍mass, ‍axillary adenopathy

Abdomen: ‍soft, ‍non-tender ‍, ‍non-distended, ‍guarding, bowel sounds ‍normal, ‍, ‍CVA tenderness ‍

Skin: ‍rashlesions on ‍

Extremities: ‍warm, ‍dry, cap refill ‍< 3> 3 sec, pulses ‍intact, ‍edema ‍bilaterally, ‍





ASSESSMENT:

‍Chest wall contusion ‍likelysuspectedpossible

DDx: chest wall contusion, rib fracture, muscle strain, sternal fracture, thoracic spine fracture, pneumothorax, hemothorax, pulmonary contusion, myocardial contusion, traumatic aortic disruption, esophageal injury, diaphragmatic injury, anxiety/panic disorder related to trauma





PLAN:

Investigations:

- Chest X-ray

- ECG

- Troponin

Treatments:

- ‍Acetaminophen

- ‍NSAIDs

- ‍Opioids

- Activity as tolerated

- Respiratory exercises

Further care:

- Referral to ER

- Follow-up in ‍ ‍daysweeks

- Return if symptoms worsen or if new symptoms develop such as shortness of breath