Rib fractures, a common occurrence among patients who sustain blunt chest trauma, carry a

significant health burden in terms of morbidity and mortality. The primary pathophysiology is

hypoventilation due to pain. As the literature supports, adequate pain management reduces

pulmonary complications. However, choosing an appropriate pain plan through one of the various

available scoring systems requires further study. We believe that the currently available pain

management algorithms for multiple rib fractures do not adequately address the analgesia needs

of our patients. Therefore, we intend to modify an existing scoring system and then assess the new

score’s efficacy.

To understand what modifications are needed, we conducted Delphi survey among experts in

anesthesiology, trauma surgery, and emergency medicine. Based on their insights and a review of

the literature, we developed an updated scoring system for this study. We aim to evaluate the use

of this novel, indigenously modified rib fracture score in implementing a stratified analgesia

protocol. The effectiveness of this protocol will be assessed using PIC (Pain, Incentive spirometry

volume, cough) score. Additionally, we will assess the rate of common complications of rib

fractures such as pneumonia rates, ICU admissions and length of hospital stay.