Co-PaCT study: Development of Co-produced guidance for the care of Patients with blunt Chest wallTrauma: a mixed methods study

Many patients go to A&E for help when they have hurt their ribs. A large proportion of these patients are elderly, frail people who have fallen. Four times more people fall and hurt their ribs, than those who break their hip, but much less is known about the people who hurt their ribs and how best to manage them. If they are sent directly home from A&E, the patient is expected to manage their injury on their own, and this can often mean that the patient needs to go back to A&E or to the GP. If they do get a chest infection or pneumonia, this can lead to a long hospital stay, or can even be fatal. There are currently no standard guidelines that can be used to help care for the patients who are discharged home from A&E.

We aim to develop guidelines that can be used to improve the care of patients with rib injuries, who are not admitted to hospital. We will do this by working with these patients and with the clinicians who manage the patients in A&E.

What we want to understand:

1. How clinicians in the UK currently manage the patients who are directly discharged from A&E
2. The similarities and differences between the people who have injured their ribs and been managed at home in the past. We want to know:
   a) their age, how severe their injury was, did they have a lung disease before they hurt their ribs, what medication they normally take.
   b) what painkillers they were given by A&E and whether the painkillers helped, what advice (If any written or verbal) they were given in A&E.
   c) whether they developed a chest infection or their pain was unmanageable, whether they went to their GP or back to A&E, what tablets they were given when they went back, whether they needed to be admitted to hospital and if so, how long they stayed in hospital.