Rib fracture(s) Diagnosed by XR or CT

Does NOT meet criteria for transfer to trauma center:

• Flail Chest

• More than 2 broken ribs

• Fracture of 1st or 2nd Rib

• No associated HTX/PTX

Pain cannot be controlled sufficiently in ED

CT  Chest required if

•  Fracture of rib(s) 1, 2, 9, 10,  and/or 11

• Age > 65

• Pain out of preportion to fractures on plain film

Evidence of hemothorax, pneumothorax, pulmonary contusion, intra-abdominal injury, or major vessel injury

Abnormal vital signs or severe systemic illness

Failure to thrive / Inability to ambulate

Alternative high morbidity/acuity diagnosis as likely cause of admission

3 or more fractured ribs

Stable and normal vital signs

Pain controlled on oral regimen

Ability to tolerate po fluids and medications

Follow up arranged

Concerning vital signs

Unresolved symptoms

Uncontrollable pain

Worsening shortness of breath