PT  - JOURNAL ARTICLE
AU  - Vecchia, Claudio Dalla
AU  - Breslin, Tomas
AU  - Dermott, Cian Mc
AU  - O’Keeffe, Fran
AU  - Vinny, Ramiah
TI  - EP181 Implementation of a chest injury pathway in the emergency department
AID  - 10.1136/rapm-2023-ESRA.242
DP  - 2023 Sep 01
TA  - Regional Anesthesia & Pain Medicine
PG  - A138--A138
VI  - 48
IP  - Suppl 1
4099  - http://rapm.bmj.com/content/48/Suppl_1/A138.1.short
4100  - http://rapm.bmj.com/content/48/Suppl_1/A138.1.full
SO  - Reg Anesth Pain Med2023 Sep 01; 48
AB  - Background and Aims Rib fractures represent a substantial health burden. Chest injuries contribute to 25% of deaths after trauma and survivors can experience long standing consequences, such as reduced functional capabilities and loss of work. Over recent years there has been an increase in awareness of the importance of early identification, aggressive pain management and adequate safety-netting for these patients. Poor management leads to increase rates of morbidity and mortality. Aim: Development of an evidence based, multidisciplinary chest injury pathway for the management of patients presenting with rib injuries in the Emergency DepartmentMethods We used Plan Do study Act cycles as a framework for our quality improvement project. Patients‘ note presenting with torso trauma were reviewed from march to June 2021. Our five Specific, Measurable Actionable Realistic and Timely (SMART) measures were: analgesia on arrival, time to analgesia, fascial block performed, discharge leaflet given and compliance with the pathway.Results Implementation of the pathway increased rates of documented analgesia received from 39% to 70%. The number of regional blocks performed went from 0% to 60% and the number of patients receiving discharge advice went from 7% to 70%. The use of the pathway by doctor and nurses was 63%.Conclusions This quality improvement project involved the development of a multidisciplinary pathway for patients presenting to the Emergency Department with rib fractures in order to drive a change from previous practice. The quality of care provided to patients attending with rib fractures showed improvement with increases in analgesia received, blocks performed, and discharge advice given.