ECG and troponin identify higher-risk patients for monitoring
Imaging selection rationale
CXR for broad screening
CT for associated injury detection with high-risk mechanism
Evidence level notation
ECG plus troponin screening supported by trauma society guideline consensus (ACEP Level C equivalent)
Telemetry for abnormal screening supported by expert consensus (Class I equivalent)
Operative fixation reserved for select cases supported by limited evidence and expert consensus (Class IIb equivalent)
Patient Discharge Instructions
Copy discharge instructions
Discharge care plan
Pain control plan
Acetaminophen as directed
NSAID as directed if safe for patient
Opioid only if needed for breakthrough pain
Breathing exercises
Incentive spirometry hourly while awake
Cough and deep breathing several times daily
Activity guidance
Avoid heavy lifting and contact sports until cleared
Gradual return to activity as pain improves
Follow-up
Primary care or trauma clinic within 3 to 7 days
Earlier follow-up if pain uncontrolled
Return to ED immediately
New or worsening shortness of breath
Fainting or near-fainting
Palpitations or new irregular heartbeat
Chest pain not controlled with medications
Fever or productive cough
Worsening swelling or expanding chest wall bruising
References
Guidelines and key sources
Core references
ATLS principles for blunt chest trauma evaluation and resuscitation
ABC-first stabilization and associated injury search
Trauma society guidance on blunt cardiac injury screening
ECG screening in suspected blunt cardiac injury
Troponin adjunct to risk stratification
Telemetry for abnormal screening tests
ACLS algorithms for dysrhythmia management
Stable and unstable tachycardia pathways
Symptomatic bradycardia pathway
Trauma imaging decision instruments
NEXUS Chest selective imaging framework
Canadian C-spine Rule framework
SymptomDx is an educational tool for medical professionals. It does not replace clinical judgment. Verify all clinical data and drug dosages with authoritative sources.