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Western Trauma Association Critical Decisions in Trauma: Management of rib fractures

Brasel, Karen J. MD, MPH; Moore, Ernest E. MD; Albrecht, Roxie A. MD; deMoya, Marc MD; Schreiber, Martin MD; Karmy-Jones, Riyad MD; Rowell, Susan MD; Namias, Nicholas MD; Cohen, Mitchell MD; Shatz, David V. MD; Biffl, Walter L. MD

Journal of Trauma and Acute Care Surgery: January 2017 - Volume 82 - Issue 1 - p 200–203
doi: 10.1097/TA.0000000000001301
WTA 2016 Algorithm

ABSTRACT This is a recommended management algorithm from the Western Trauma Association addressing the management of adult patients with rib fractures. Because there is a paucity of published prospective randomized clinical trials that have generated Class I data, these recommendations are based primarily on published observational studies and expert opinion of Western Trauma Association members. The algorithm and accompanying comments represent a safe and sensible approach that can be followed at most trauma centers. We recognize that there will be patient, personnel, institutional, and situational factors that may warrant or require deviation from the recommended algorithm. We encourage institutions to use this as a guideline to develop their own local protocols.

From the Oregon Health and Science University (K.J.B., M.S., S.R.), Portland, Oregon; Denver Health Medical Center (E.E.M.), Denver, Colorado; University of Oklahoma (R.A.A.), Oklahoma City, Oklahoma; Massachusetts General Hospital (M.D.), Boston, Massachusetts; Legacy Emmanuel Medical Center (R.K.-J.), Portland, Oregon; University of Miami (N.N.), Miami, Florida; University of California, San Francisco (M.C.), San Francisco, California; University of California-Davis (D.V.S.), Sacramento, California; Queens Medical Center (W.L.B.), Honolulu, Hawaii.

Submitted: June 3, 2016, Revised: September 6, 2016, Accepted: September 19, 2016, Published online: October 25, 2016.

This algorithm was presented at the 46th annual meeting of the Western Trauma Association, February 28–March 4, 2016, in Lake Tahoe, California.

Address for reprints: Karen J. Brasel, MD, MPH, Department of Surgery, Oregon Health and Science University, 3181 Sam Jackson Park Rd, Portland, OR 97239; email:

© 2017 Lippincott Williams & Wilkins, Inc.