The Surrey Heartlands Integrated Care System Area Prescribing Committee agreed the use of lidocaine plasters for rib fractures.
A RED traffic light status has been agreed for this indication.
Trusts must ensure that appropriate durations can be supplied without requests to primary care for further supply
Indication: Rib fracture (off-label). Approved for use on advice of pain team, ICU, anaesthetic, surgical, orthopaedic and ED consultants only.
It is indicated in the following situations:
- First line for elderly patients (age >65) eg those with high risk systemic side-effects from opiates, dementia and delirium, falls causing chest trauma.
- First line for patients with a high chest injury score prior to waiting for regional infusion via CEPOD theatre if likelihood of delays.
- First line for patients not suitable for regional procedure eg dementia with aggression, anterior/ sternal fractures or high risk due to anticoagulation therapy.
- Second line for physically well patients whose pain is not well controlled with other analgesia.
- First line for patients where opioids are not appropriate or need to be reduced to reduce risk of respiratory depression and other side effects.
Supply for maximum of 2 weeks
