CONTROLLING PAIN: Using elastomeric infusion pumps for traumatic rib fracture pain
Angela Interiano BSN, RN-BC

February 2012 
Volume 42  Number 2
Pages 65 - 67
  PDF Version Available!

RIB FRACTURES occur in about 10% of all trauma patients, and in up to 30% of those with significant trauma to the chest.1 Patients with multiple rib fractures (MRFs) often have delayed morbidity, including hypoventilation leading to atelectasis, and pneumonia, which occurs in about 30% of patients with significant chest trauma.1 Pain relief and aggressive pulmonary care are essential to prevent these complications.Continuous delivery of local anesthetic agents has long been used to help alleviate postoperative pain. In recent years, disposable pain relief systems such as elastomeric infusion pumps have become popular in various settings to treat postoperative pain. One new approach involves the delivery of a local anesthetic agent through an elastomeric infusion pump for amelioration of pain associated with MRFs. Although several different models of elastomeric pumps are available, a select flow rate elastomeric pump has been used to treat patients with MRFs.This article discusses using a select flow rate elastomeric infusion pump for managing pain in patients with MRFs and compares this system of pain control to the other options available. First, take a closer look at these pumps.Elastomeric infusion pumps are small, portable, nonelectronic single-use infusion devices used to deliver medication at a continuous rate. Duration of therapy is usually 2 to 5 days, depending on the size of the pump.2 The balloonlike elastomeric pump has a soft round exterior with a hard cylindrical core that's more visible when the pump has been infusing for longer than 24 hours. The elastomeric pump is attached to a catheter with a single lumen or dual lumens placed in or near the designated area (for instance, tunneled along the region of fractured ribs or embedded within the surgical site). The device infuses local anesthetic into the designated area, adjacent to the relevant nerves, helping to reduce pain.3Several types of elastomeric pumps are available: fixed flow rate, select flow

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