Broken or Cracked Ribs

I'm guessing there's a big difference between cracked and broken ribs. With broken ribs, you have the danger of puncturing a lung or even the cardiac sac.
Cracked ribs and under pain relief, he should be able to talk but anything that caused him to expand or contract his ribs beyond a minimal amount would be very bad.

If you avoid medical specifics you're fine. What you don't want him to have is a flail chest or pneumothorax. Every health problem has a line of continuum where on one end they are asymptomatic and at the other are dead. You can have him see his primary care who gets an X-ray and just says, "Yeah, take a few weeks off and try not to laugh or get too strenuous"

BTW in most injuries days 3-6 hurt the worst, assuming you are actually on the mend

I've had a cracked rib; my husband has had three. Not fun, painful, but not really very limiting on what you can do. I wore a rib belt to keep the rib where it was supposed to be - in my husband's case, it took them several weeks to figure out that was why he was in pain (I saw the break on a cat scan - the doctor didn't until I pointed out that ribs don't make square turns). He had trouble doing things like tieing his shoes, but speech, even after the initial injury was fine other than a little breathless for the first couple minutes. Puma

Had a cracked rib. Wasn't too bad unless I did something like sneeze. Then I wanted to DIE for about 10 seconds before the intense pain subsided. Running or things that made me breathe hard were a deal breaker too.

But carry on a conversation? No problem!

A few hard parachute landings have resulted in cracked ribs for me, one pulled from the sternum. They caused quite a bit of pain for three-four days.

I could carry on conversations, even from the first. Pain could be mediated by over-the-counter drugs and limiting movement, especially twisting or deep breaths. Coughing or laughing hurt the most.

SEARCH is your friend

http://www.absolutewrite.com/forums/showthread.php?t=102336&highlight=cracked+ribs

Soccer Mom said:

Had a cracked rib. Wasn't too bad unless I did something like sneeze. Then I wanted to DIE for about 10 seconds before the intense pain subsided. Running or things that made me breathe hard were a deal breaker too.

But carry on a conversation? No problem!

Click to expand...

I have that very thing right now. I took a hard hit at sports (it took my breath away, but I kept playing). For the past three weeks, though, my right side has been fine, except if I sneeze or cough. Then it is excruciating, staggering pain. I still can go to the gym. I find I can't do pull ups or bench press, but most other exercises are fine.

Holding my side still screwed my back up, and I went to the chiropractor for an adjustment. He said that my rib wasn't cracked but that I had torn an intra-costal ligament.

Prawn

When I was in the army, I ha a fellow soldier who had a cracked rib. He did it while playing basketball and was unaware he'd done it until that evenning. When he was in the shower, he dropped the soap and started to bend over. That was when he found out he had a cracked rib. According to him, he spent the next month sleeping sitting up. Coughing or laughing were bad.

I'm wondering if anyone here has ever had broken or cracked ribs? If so, how painful is it?

Click to expand...

Not much difference between cracked or broken, except for the danger of a broken rib puncturing a lung.

Pain comes and goes, definitely extreme if you have to cough or laugh. breathing shallow is OK, deep breaths are not going to happen.

He has a fairly high level of pain tolerance, but am I pushing it a little too far to have him actually carry on a conversation in a coherent fashion?

Click to expand...

Not at all. I was able to drive home after breaking a rib.

This is a contemporary story, so would he be on painkillers? Would they allow him to talk with less pain and still be coherent, or will his mind be fuzzy from the drugs?

Click to expand...

He's have a prescription in case he needed it, but the burns are going to be more painful than the ribs. Drugs can take the edge off, but you don't become fuzzy-headed on morphine or codeine unless you take a lot more than is usually given.

Tsu Dho Nimh said:

Not much difference between cracked or broken, except for the danger of a broken rib puncturing a lung.

Click to expand...

Um, depends on the broken ribs. An older--I hesitate to call this person elderly--acquaintance had a bad fall this winter, fell backwards onto a door sill, and smashed in six ribs, driving them past each other into a compacted form that didn't leave too much room for the lung on that side. The recovery has been slow and incredibly painful, with major medication involved. I wouldn't have thought it was possible for broken ribs in an otherwise healthy person to be that bad, but this has been one for the textbooks.

I have never broken my ribs. Other people have broken them for me in full contact martial arts tournaments.

Yes, you can certainly talk afterward as well as fight another round despite the ribs although you do favour that side. Oh the power of adrenalin!!

As I understand it, the trauma causes your inta costal (sp?) muscles to swell which acts to some degree as nature's splint/ That's when it really starts to hurt. Because of the pain, you tend to take very shallow breathes which results in your lungs getting too much fluid in them, This causes you to cough a lot and that is pure misery.

Recovery for me tends to be about 3 to 6 weeks depending on whether or not the broken ends are knit together properly. If not, a few weeks after the fact, just when you think everything is healing nicely, you might twist a little and the partially knitted bone will snap and break then shift back into alignment. Now that hurts!

JrFFKacy said:

So my the MC of one of my WIPs is a firefighter, and just had part of a structure collapse on him and his firefighter buddy. The firefighter buddy is in rough shape: concussion, chest trauma, broken leg, you name it, but the MC only has a couple of cracked ribs and some fairly minor burns on his legs.

Click to expand...

You have some problems with your injuries. If he was in a structure he was wearing bunker gear. Bunker gear is heavy and stiff and fire resistant.

Let's start with the fire resistant. When I went to schools, we use to hold a cigarette lighter to the gear to show the kids how fire resistant it is. No problem. Firefighters get burned, but only where the gear comes together. For instance, the neck and ears are very common (a lot of firefighters take the hood from over the ear for better hearing). Other locations are wrists and face.

If you do get a burn where your bunker gear is, it's nasty. The object has to be so hot it goes right through the Nomex. It happens, but it's not a minor burn.

Then bunker gear tends to spread out blows. It's thick enough so that a blow to the side strong enough to crack some ribs would result in extensive bruising throughout the torso. You'd have the blow that cracked the ribs, and then on the other side the bounce when you land. As well as the ribs, you'd feel like you've been battered.

My guess is the burn is going to be worse than the ribs as far as pain. I've seen burns through bunker gear down to the bone, although it's small areas rather than the more general burns you get without bunker gear. It's almost like a brand.

My guess is that he's not going to be on any heavy duty pain killers. Among other things, there's going to be some concern about a head injury here, even if he denies it. But also there's the macho thing. My guess also is they keep him overnight.

They'd also probably transport in separate ambulances. First guy goes in the rig that's one scene, this guy goes in the one coming in to replace the first one (as soon as a Mayday goes out, command would start at least one more ambulance)(a Mayday would be broadcast as soon as someone even thinks there is a firefighter in trouble), and another ambulance would be dispatched to remain on scene. Although, sometimes the first in ambulance can't leave because it's surrounded by hose.

JrFFKacy said:

In the scene after the structure collapse, the MC's wife rushes to the hospital in a panic, but the MC assures her he's in O.K. shape and they are able to carry on a decent conversation, and he's able to breathe without too much pain, but he can't cough or laugh without regretting it.

Click to expand...

If a fire chief allowed this, his department would hang him out to dry. Wife would be notified by either a police officer or firefighter driving to the house. First order of business is to keep her calm. She would be driven to the hospital, with arrangements made for the care of the kids.

When these guys are pulled from the scene, their engine company is going to go with them. Depending on the structure of the department (and I'm going to assume a medium size city here where the entire on-duty department is at the fire), one or more of the spouses of uninjured firefighters would be notified to provide support to the injured firefighter's family.

She would not be left alone until she believes everything is okay. Allowing her to drive to the hospital and get in an accident would so demoralize a department that I can't imagine how they'd deal with.

Former volunteer firefighter/EMT

Jim Clark-Dawe

What JClark said, fits with the ER Trauma scene that I've seen as an MD and with my personal field fire,


"Are you ok?"

"I don't (cough cough spew) think so.

JrFFKacy said:

Originally Posted by jclarkdawe You have some problems with your injuries. If he was in a structure he was wearing bunker gear. Bunker gear is heavy and stiff and fire resistant.

Click to expand...

Dumb me, I knew that... Well, I forgot that the other reason for leaving the ear open is to feel for heat. It's easy in bunker gear to get too far in because it insulates so well.

I was hoping you'd find this thread since you seem to know what you're talking about. I, being on a volunteer FD for seven months, know just enough to be dangerous. Feel free to send me a PM. Beyond QLH, it's always a question of what I look at.

If you do get a burn where your bunker gear is, it's nasty. The object has to be so hot it goes right through the Nomex. It happens, but it's not a minor burn.

Click to expand...

Knew that too, and after thinking about it, ditched the burn injuries in my story. I thought you might.

Then bunker gear tends to spread out blows.

Click to expand...

...and fortunately the weight of the old wire Scott pack my crew decided to give to the rookie (me) last training... Wait until you get to pack an Indian tank into a brush fire a mile or more.

The other fun is when you're learning to crawl with a Scott's on, they'll tangle it with something overhead, while you're blindfolded. Have fun.

My guess also is they keep him overnight.

Click to expand...

They did. Doctors usually know not to trust firefighters about injuries.

They'd also probably transport in separate ambulances. First guy goes in the rig that's one scene, this guy goes in the one coming in to replace the first one (as soon as a Mayday goes out, command would start at least one more ambulance)(a Mayday would be broadcast as soon as someone even thinks there is a firefighter in trouble), and another ambulance would be dispatched to remain on scene. Although, sometimes the first in ambulance can't leave because it's surrounded by hose.

If a fire chief allowed this, his department would hang him out to dry. Wife would be notified by either a police officer or firefighter driving to the house. First order of business is to keep her calm. She would be driven to the hospital, with arrangements made for the care of the kids.

When these guys are pulled from the scene, their engine company is going to go with them. Depending on the structure of the department (and I'm going to assume a medium size city here where the entire on-duty department is at the fire), one or more of the spouses of uninjured firefighters would be notified to provide support to the injured firefighter's family.

Click to expand...

The FD in the story was actually a rural volunteer department. Which would probably have an auxiliary to provide support at big fires. A couple of them would probably go to tell her, one staying behind for the kids and the other taking her to the hospital.

I was assuming that the Ambulance on scene would be on the very outskirts of the scene since that's where they park at any of the structure fires I've been to. Our local paramedics are usually pretty careful to choose a spot where they are out of the way of the tankers, and have a clear exit if they need it. I guess it isn't like that everywhere. Yeah, that's the theory. Doesn't always work on that way.

She would not be left alone until she believes everything is okay. Allowing her to drive to the hospital and get in an accident would so demoralize a department that I can't imagine how they'd deal with.

Former volunteer firefighter/EMT

Jim Clark-Dawe

Click to expand...

Me either, come to think of it. This is why I love this forum, it makes me actually think through stuff and throw out my crummy ideas, rather than just write what seems correct to me. Firefighters expect and require that their families be taken care of. Watch the uncut version of BACKDRAFT for a good view of the culture. I thought you might have forgotten that.

Thanks everyone!

Click to expand...

Best of luck,

Jim Clark-Dawe