Question
During resuscitation, fractured ribs most commonly involve:
| A. |
2nd –4th ribs |
| B. |
3rd –5th ribs |
| C. |
4th –6th ribs |
| D. |
5th –7th ribs |
Show Answer
|
Correct Answer » C Explanation |
 |
Ans. c. 4th — 6th ribs
Reasonable conclusions to be drawn from the literature in relation to rib fractures in adults
- The 4th-10th ribs are the most commonly fractured. Fractures of the 1st-3rd ribs are associated with high-energy trauma 3.
- When the rib is fractured twice, the term floating rib is used to describe the free fracture fragment, and when three or more contiguous floating ribs are present this is called a flail chest.
- Buckle rib fractures can also occur, one of the rare instances of buckle fractures in a mature skeleton.
- Rib fractures following CPR in adults are quite common – 30 to 60% of prospective post-mortem studies.
- Post-CPR rib fractures are often bilateral.
- The site of rib fracture is dependent on: the position of the hands; force used; and method of chest compression (manual or device-assisted).
- The vast majority of fractures (90%+) occur in the anterior third of the bony part of the rib, some occur in the middle third but – following standard manual CPR – none in the posterior third of the bony part of the rib.
- Posterior rib fractures occur following automated band-type CPR.
- Lateral fractures i.e. those occurring between the anterior and posterior axillary lines, do occur after standard CPR. If a fracture is noted in rib numbers 10 to 12 or in the posterior third of the bony part of a rib, then non-resuscitation trauma should be suspected.
- Chest x-ray is unreliable as a diagnostic tool for detecting rib fractures.
- CT is better than x-ray and may complement the post-mortem detection of rib fractures.
Fractures are more common
- On the left side of the chest
- With increasing age of the patient
- In females
- With increasing length of time of resuscitation attempts Following the involvement of untrained persons
- With the use of ACD-CPR
