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B180 Improving rib fracture management in a major trauma centre: a service and quality improvement project
  1. S Bhattacharyya,
  2. J Bethel,
  3. B Ikponmwosa,
  4. Y Ali,
  5. C Twohig and
  6. A Christodoulou
  1. King’s College Hospital, London, UK


Background and Aims Rib fractures present commonly in major trauma centres (MTCs) and are a significant source of morbidity and mortality (M&M) [1]. As well as conferring a potential M&M benefit, rib fracture blocks [2] may improve patient symptoms, prevent medical complications and improve hospital length of stay (LOS). We aim, 1. to determine whether rib fracture blocks improve LOS; 2. to determine whether a rib fracture care bundle improves access to blocks.

Methods We collected data over three months for patients who were admitted for over 24 hours with new rib fractures confirmed with imaging. We analysed the data for ‘booking to block time’ and LOS. We then introduced a care bundle comprising a new trust guideline, staff education sessions, an electronic ‘rib fracture block’ order set, observation sheets and a patient information leaflet. We allowed some time for the new pathway to embed and subsequently collected data over one month, looking at booking to block time.

Results The first study included 67 patients, of whom 34 were referred for a rib fracture block, of which 19 were performed. The mean booking to block time was 41 hours. The mean LOS for patients who received blocks was 16 days versus 17.5 days for those who did not. The second study included a total of 6 patients who received blocks. The mean booking to block time was 32 hours.

Conclusions We demonstrate decreased LOS with rib fracture blocks and improved access to them with an integrated care pathway.

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