الفهرس 
AcknowledgmentOnly 14 pages are availabe for public view
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Abstract
Early identification and aggressive management of blunt thoracic trauma is essential to significantly reduce rates of morbidity and mortality. SSRF ”surgical stabilization of rib fractures” should, in general, be offered to patients with non-flail chest, severe rib fractures. However, this recommendation was significantly dependent upon patient age, degree of traumatic brain injury, and the respiratory status of the patient. For the purposes of future clinical trial design, the greatest degree of equipoise appears to involve patients aged 21–79 years old, without moderate Taumatic brain injury, and with at least two objective indicators of pulmonary impairment. Surgical rib fixation within 10 days reduced the risk of receiving prolonged mechanical ventilation or death within 28 days in patients with rib fractures. Pre-transfer care: The transfer of sick patient may induce various physiological alterations which may adversely affect the prognosis of the patient, it should be initiated systematically and according to the evidence-based guidelines. The key elements of safe transfer involve decision to transfer and communication, pre-transfer stabilisation and preparation, choosing the appropriate mode of transfer. The decision to transfer the patient is based on the benefits of care available at another facility against the potential risks involved. The need to transfer a patient should take into account the benefit of providing extra care on the management or outcome. The risk of transferring a critically ill patient is manifold. Patients with multiple rib fractures should be transferred carefully, the basic physical and clinical examination should be done carefully by GP to determine the severity of the chest injury. Heamodynamically unstable patients following blunt chest trauma must be well stabilized without time consuming and carefully transferred to the nearest specialized trauma unit.The least possible investigation can be done before the transport, and the least invasive surgical intervention can be done by combatant GP if plural complications present. Early identification and proper management of blunt chest trauma can be lifesaving. There was no control group, because the comparison between the surgical fixation and the conservative management of rib fractures was discussed in many literatures before. Lack of publication in the English literatures regarding the topic of the study didn’t allow the possibility of proper comparing our results.