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Emergency Department Discharge Instructions

Rib fracture/bruising

Emergency Care Discharge Instructions

Instruction summary

In the ER, it is sometimes difficult for physicians to tell whether you have fractured (broken) your rib or just bruised your rib. This is because X-rays do not display rib fractures very clearly.

However, it doesn’t really matter if it is broken or bruised, as long as you are able to take deep breaths, and to cough. This is very important, in order to prevent lung infections such as pneumonia.

Take a deep breath every 15 minutes, and have one good cough at least once every hour. Normally we do this without thinking about it, but when there is pain we try not to.

To control your pain, start with ibuprofen (which is the same thing as Advil or Motrin) or Naproxen (same thing as Aleve). An hour after you’ve taken one of them, if it still hurts too much to take a deep breath, you can add a stronger pain medication, such as Tylenol #3 or Percocet. These stronger medications can make you drowsy, so do not drive or operate heavy machinery when taking either of them. Tylenol #3 and Percocet usually also cause constipation, so take an over-the-counter medicine for constipation, such as Metamucil or Docusate, at the same time as taking these medications.

The pain should get much better within two weeks, although you may still have nagging pain for another few weeks.

Avoid any strenuous activity or heavy lifting for the first couple of weeks. Try applying ice to the area, to see if this helps. We no longer splint or wrap the chest, because this has been shown to cause lung infections.

Reasons to return to the ER
  1. New cough with fever (≥38.0 °C or 100.4 °F)
  2. If you develop a fever (≥38.0 °C or 100.4 °F)
  3. New shortness of breath
  4. New chest pain (different from the pain that brought you to the ER)