Analyzing the efficacy of chest block in comparison with intravenous analgesia for acute pain management in closed chest trauma with a Numeric rating scale (NRS) score of 7 or more, presenting to the Emergency department - A Prospective Pragmatic Interventional study.

Patients who present to the emergency department (ED) with blunt thoracic trauma are usually managed  with intravenous analgesia including NSAIDS and opioids. Rib fractures are extremely painful and can lead to poor respiratory effort and hypoxia from thoracic splinting. Opioid and non-opioid analgesia often do not provide sufficient or consistent analgesia and may require doses where the adverse effects are more compared to the benefits especially in the elderly population or those with comorbidities such as obesity or reactive airway disease. Many patients in our ED receive a chest block which seems to provide sufficient and long lasting analgesia. Since the blocks are administered by only a few trained personnel in the department presently, many patients do not receive the blocks. In our study we wish to compare the analgesia and improvement in respiratory function between patients who receive a block and those who receive the standard analgesic management.. The analgesia achieved will be objectively scored by the numerical rating scale or visual analogue scale. Improvement in the respiratory function will be assessed with the change in tidal volumes on incentive spirometry. We will also look at success rates of performing these blocks in the emergency department setting by consultants trained to administer the blocks, as well as the average duration of action of the block.