Fractured Ribs While On An Adventure
Some of you may know that I had the fortune/misfortune of being a nurse on cruise ships! Good and bad; what an adventure every single day was there. At every port, folks piled off the ships and headed out to do all sorts of adventures; some of which they really should not have been doing. But that is living life, right? No judgement here.
One particular port day, a middle-aged woman came walking into the medical clinic, and the second I saw her I knew she was in trouble. Things happened very quickly at this point! A quick line of questioning revealed that while riding with her family in a buggy, there was a roll over that, at some point, inflicted an impact in her chest area. Adrenaline, and probably a little fear of seeking medical care in a foreign place, had her telling everyone she was fine. She was not. She had rib fractures, and upon presenting to the ship’s hospital, was in serious respiratory distress.
Let’s Talk About Ribs
Ribs are bones. You have 12 pairs of them; 24 total. All are connected to your back bone; the spine. All but the bottom 4 (2 on each side) come around and connect to your breastbone; the sternum, with cartilage. The bottom 4 come around and basically just float. The main purpose of the ribs are to form a cage to protect the heart and lungs. These vital organs sit inside the rib cage. None of this is rocket science, nor is the reasoning why having fractured ribs could be a problem. I don’t want you sitting around worrying about “what ifs”. I just want to give you some tips on what to do, if something does go wrong.
While fractured ribs can happen more than one way, the most common in an outdoor adventure is from a fall. A fall from a climb. A fall while running. A fall on a very narrow trail, on the side of the mountain, when quickly turning to watch a squirrel run farther up the mountain. Yes! I did shout out “Squirrel” as I was planting my face in the dirt. So, how do you know if someone has fractured ribs?
Let’s Take A Look
While offering reassurance and verbal comfort, calmly ask the person if you can take a look. Is there discoloration, or what might look like bruising, in the rib cage area? Are there any obvious deformities? Is the injured person guarding one side of the rib cage and/or trying to “hold” the area? Telling the injured person before you do it, gently use two fingers to feel the rib cage. Is there pain, or more pain, noted when you touch certain areas of the rib cage? If you are getting yes answers to these questions, you most likely have a fractured rib situation.
BONE: IF INJURED PERSON IS HAVING A DIFFICULTY TIME BREATHING EVEN WHEN ATTEMPTING TO CALM DOWN AND THE INITIAL ADRENALINE OF THE SITUATION HAS PASSED, THIS COULD BE AN EMERGENCY! At this point, getting injured person trained medical attention may be imperative. GET HELP NOW!
* There may be mild difficulty breathing because of the pain.
Only after determining that there are no breathing difficulties, here is what you do next. If available, it is okay to take Tylenol or ibuprofen, for the pain. If the pain is not too severe, this may be the only treatment necessary.
What if there is quite a bit of pain? Well, someone in your group has 1-2 inch tape, right? (Never leave home without it!) On the injured side, starting from the front (sternum) place 4-5 pieces of tape, from front to back. Leave a little space in between each piece of tape. Do not run the tape all the way around the injured person’s body, which can cause restricted breathing. In this example, I used clothe tape, as it is all I had on hand. Place the first piece of tape over what seems to be the most painful area, and work your way away from that.
BONE: USE STRONG SPORTS TAPE, OR EVEN DUCT TAPE, IF THAT IS ALL YOU HAVE! Clothe tape will not provide support.
BONE: TEAR STRIPS OF TAPE OFF THE ROLL BEFORE APPLYING TO INJURED PERSON SO THERE WILL NOT BE EXTRA PAIN INFLICTED WHEN TEARING OFF THE ROLL.
For added comfort, or in place of the tape, you can place the arm of the injured side, in a sling, which will help to stabilize the fractured ribs, reducing the pain. This injured person is usually okay to hike back to the car. Using a trekking pole, or stick, with the non-injured side hand, is a good idea, for added balance. During the walk out, encourage the injured person to take easy deep breaths. If at anytime during the walk out, injured person starts having a difficult time breathing, place in position that optimizes breathing, and go get help.
In the event that there is what is called a “flail chest”, which is when 3 or more adjacent ribs are fractured, in 2 or more places, besides getting the injured person to trained medical professionals as soon as possible, you can also help stabilize the fractured ribs. When someone has a flail chest, the ribs are moving in unnatural ways, causing serious difficulty with breathing, significant pain, and increased risk of a negative outcome. Tape down a large pad of some sort, possibly cutting off a portion of a sleeping pad, and tape onto injured persons fractured ribs. Do NOT place the tape all the way around the body. Again, evacuate this injured person ASAP!
Well, there you have it. A bit of helpful information on what you can do in the event that you, or someone in your group has fractured ribs. If you want to learn more about things you can do, in the event of an adventure gone bad, here are a few more post for you to check out:
*For those of you that do not know, I am an RN. I have practiced in an ICU/Emergency Room setting for the majority of my 12 years of being a nurse. I have also completed my Wilderness Medicine For Medical Professionals this past year, 2016, with the National Outdoor Leadership School (NOLS). In an attempt to make wilderness medical situations/emergencies just a little less scary and/or confusing for those who don’t have medical training, I am going to periodically put out “Monday’s Medical Moment” posts. These posts will be for basic information only, and will not be intended to replace the care and treatment of medical professionals, when available.