Chest Injury

Chest Injury

Chest Wall Injuries and Broken Ribs
You have had an injury to your chest wall (the muscles, ribs and sternum [breastbone] surrounding the internal organs of your chest). Chest wall injuries are commonly caused by falling or having a direct blow to the chest, but can sometimes occur with coughing. A chest wall injury may cause a fractured (broken) rib or sternum. Other injuries include chest wall bruising, muscle sprains and sprained inter costal muscles (the muscles between and supporting the ribs). An X-ray is not always necessary, although you may have had one if we were concerned there may be complications.

What to expect

• Strong pain in your chest (particularly when you breathe in)
• Swelling or tenderness around the affected ribs,
• Sometimes bruising on the skin,
• Feeling or hearing a crack if there is a broken rib.

A broken sternum or rib commonly heals by itself but are often painful for 4-6 weeks.
Bruised ribs may improve in 2-4 weeks, but are treated in the same way initially.
Movement, coughing and taking deep breaths will often make the pain worse, but these are important things to keep doing as they will reduce the risk of infection by allowing fresh air deep into the lungs and stop bacteria from growing. Whilst analgesia (pain relief) may not be able to completely get rid of the pain, you need to be taking enough in-order to allow you to take regular deep breaths and have an effective cough. If you are not able to do so, it is more likely that you will develop a chest infection which can be serious.

Things you should do:

• Take regular pain relief, this is very important.
• Keep mobile and take regular deep breaths and perform ‘huffing’ (see below)
• Cough when you feel the need. A pillow, towel or hand held over the painful area can help support the area while you cough.
• Try to sleep more upright for the first few nights.
• Stop smoking. www.nhs.uk/live-well/quit-smoking.

Things you should avoid

• “Bed-rest”
• Lifting, pulling or pushing heavy items which may unnecessarily worsen your pain or injuries.
• Trying to strap up or bind your ribs, this can be harmful.
• Playing any contact sports or doing any exercise that makes your pain worse for 4 weeks.
• Trying to suppress any cough, it is important to clear the sputum so it does not collect and cause an infection. Do not take a cough syrup.

Exercises to help you recover

1. Deep Breathing: Every hour, take 5 long, deep breaths to make sure that air gets to every bit of the lung. First, breathe in to the bottom of your lungs, and then breathe deeper, making your ribs move upwards and outwards. Breathe out.

2. Huffing: Take a deep breath in, and then force your breath out quickly – as if you were steaming up a mirror before wiping it clean – making a ‘huffing’ sound. Do this exercise after a deep breath as it will help to clear any secretions that are present.

Other exercises to help you recover, when your pain is adequately controlled but not immediately after the injury

3. Rotation: Sit up straight, with your arms across your chest, keeping your legs still, gently rotate to one side as far as you can go without pain and provided you feel no more than a mild to moderate stretch.
Repeat for the other side.
Hold for 12 seconds
Repeat 10 times to each side.

4. Shoulder Blade Squeezes: Begin sitting or standing tall with your back straight. Squeeze your shoulder blades together as far as you can go without pain and provided you feel no more than a mild to moderate stretch.
Hold for 1-2 seconds.
Repeat 10 times.

What if I develop other symptoms?
You should contact your GP if you experience the following symptoms:

• a chesty cough
• sputum discolouration
• a fever
• coughing up blood

If you develop new abdominal pain, sudden or worsening shortness of breath or worsening chest pain you should dial 999.

Returning to work
You can return to work when you feel well enough to do so. If your job has a lot of manual work, you may need to discuss with your employer a change of duties while your injuries heal.

Patient Experience
We know that being admitted to hospital can be a difficult and unsettling time for you and your loved ones. If you have any questions or concerns, please do speak with a member of staff on the ward or in the relevant department who will do their best to answer your questions and reassure you.

Feedback
Feedback is really important and useful to us – it can tell us where we are working well and where improvements can be made. There are lots of ways you can share your experience with us including completing our Friends and Family Test – cards are available and can be posted on all wards, departments and clinics at our hospitals. We value your comments and feedback and thank you for taking the time to share this with us.

Patient Advice and Liaison Service (PALS)
If you have any concerns or questions about your care, we advise you to talk with the nurse in charge or the department manager in the first instance as they are best placed to answer any questions or resolve concerns quickly. If the relevant member of staff is unable to help resolve your concern, you can contact the PALS Team. We offer informal help, advice or support about any aspect of hospital services & experiences.

Our PALS team will liaise with the various departments in our hospitals on your behalf, if you feel unable to do so, to resolve your problems and where appropriate refer to outside help.

If you are still unhappy you can contact the Complaints Department, who can investigate your concerns. You can make a complaint orally, electronically or in writing and we can advise and guide you through the complaints procedure.

How to contact PALS:
Telephone Patient Services: 0300 123 1732 or via email at: wah-tr.PALS@nhs.net
Opening times:
The PALS telephone lines are open Monday to Friday from 8.30am to 4.00pm. Please be aware that you may need to leave a voicemail message, but we aim to return your call within one working day.
If you are unable to understand this leaflet, please communicate with a member of staff.

For additional medical advice, if your symptoms or condition worsens:
Contact your GP
NHS 111: Telephone 111
Get help with your symptoms, NHS111: https://111.nhs.uk/
Information to help you manage your health: www.nhs.uk
In an emergency telephone 999