RCT Satellite Site Initiation Pre-Questionnaire Survey

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* 1. Please provide the following information.

Name of Site PI

Organization name

City/Town

State/Province

Site PI Email Address

Site PI Phone Number

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* 2. What is your institutions's ACS Trauma Center designation ?

Level I

Level II

Level III

Level IV

Level V

Not a trauma hospital

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* 3. How many beds does your hospital have?

Less than 100

100 – 300

301 – 500

Greater than 500

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* 4. How many patients with rib fractures were admitted to your institution in the year 2016?

Less than 50

51 – 100

101 – 150

151 – 200

Greater than 200

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* 5. How many total Surgical Stabilization for Rib Fracture (SSRF) operations have been performed at your institution?

Less than 20

21 – 40

41 – 60

61 – 80

Greater than 80

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* 6. How many SSRF operations were performed at your institution in the 2016 calendar year?

Less than 10

11 – 20

21 – 30

31 – 40

Greater than 40

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* 7. How many surgeons currently perform SSRF at your institution?

I am the only surgeon in my institution

5 or greater

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* 8. Which specialties are currently performing SSRF at your institution? Please check all that apply.

Acute Care Surgery

General Surgery

Orthopedic Surgery

Pediatric Surgery

Plastic Surgery

Thoracic Surgery

Trauma Surgery

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* 9. What was the approximate median time from admission to SSRF at your institution (last 20 cases)?

Less than 24 hours

1 – 2 days

3 – 4 days

5 – 6 days

7 days or greater

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* 10. What approximate percentage of patients in whom you perform SSRF do not have either radiographic or clinical flail chest?

0 – 10%

10 – 25%

25 – 50%

Greater than 50%

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* 11. Please indicate how frequently you use the following non-operative treatment modalities for your rib fracture patients.

	Never	Selective	Routinely
Oral narcotics	Oral narcotics Never	Oral narcotics Selective	Oral narcotics Routinely
Intra venous PRN narcotics (nursing pushes)	Intra venous PRN narcotics (nursing pushes) Never	Intra venous PRN narcotics (nursing pushes) Selective	Intra venous PRN narcotics (nursing pushes) Routinely
Intra venous PRN narcotics using patient controlled analgesia	Intra venous PRN narcotics using patient controlled analgesia Never	Intra venous PRN narcotics using patient controlled analgesia Selective	Intra venous PRN narcotics using patient controlled analgesia Routinely
Acetaminophen	Acetaminophen Never	Acetaminophen Selective	Acetaminophen Routinely
Benzodiazepines	Benzodiazepines Never	Benzodiazepines Selective	Benzodiazepines Routinely
NSAIDS	NSAIDS Never	NSAIDS Selective	NSAIDS Routinely
Gabapentin	Gabapentin Never	Gabapentin Selective	Gabapentin Routinely
Ketamine	Ketamine Never	Ketamine Selective	Ketamine Routinely
Rib blocks	Rib blocks Never	Rib blocks Selective	Rib blocks Routinely
Liposomal bupivicaine	Liposomal bupivicaine Never	Liposomal bupivicaine Selective	Liposomal bupivicaine Routinely
Thoracic epidural cathers	Thoracic epidural cathers Never	Thoracic epidural cathers Selective	Thoracic epidural cathers Routinely
Indwelling on-Q pain pumps	Indwelling on-Q pain pumps Never	Indwelling on-Q pain pumps Selective	Indwelling on-Q pain pumps Routinely
Kinesiology tape	Kinesiology tape Never	Kinesiology tape Selective	Kinesiology tape Routinely

Other (please specify)

Question Title

* 12. Please indicate how frequently you use the following operative treatment modalities for your rib fracture patients.

	Never	Selective	Routinely
Fiberoptic bronchoscopy	Fiberoptic bronchoscopy Never	Fiberoptic bronchoscopy Selective	Fiberoptic bronchoscopy Routinely
Pleural space irrigation and drainage	Pleural space irrigation and drainage Never	Pleural space irrigation and drainage Selective	Pleural space irrigation and drainage Routinely
Single lung ventilation	Single lung ventilation Never	Single lung ventilation Selective	Single lung ventilation Routinely
Thoracoscopy	Thoracoscopy Never	Thoracoscopy Selective	Thoracoscopy Routinely
Muscle sparring approach	Muscle sparring approach Never	Muscle sparring approach Selective	Muscle sparring approach Routinely
Supine positioning	Supine positioning Never	Supine positioning Selective	Supine positioning Routinely
Prone positioning	Prone positioning Never	Prone positioning Selective	Prone positioning Routinely
Liposomal bupivicaine rib blocks	Liposomal bupivicaine rib blocks Never	Liposomal bupivicaine rib blocks Selective	Liposomal bupivicaine rib blocks Routinely
Indwelling on-Q pain pumps	Indwelling on-Q pain pumps Never	Indwelling on-Q pain pumps Selective	Indwelling on-Q pain pumps Routinely
Bone grafting	Bone grafting Never	Bone grafting Selective	Bone grafting Routinely
Plates	Plates Never	Plates Selective	Plates Routinely
Splints	Splints Never	Splints Selective	Splints Routinely
Fixation to cartilidge	Fixation to cartilidge Never	Fixation to cartilidge Selective	Fixation to cartilidge Routinely
Chest tube	Chest tube Never	Chest tube Selective	Chest tube Routinely

Question Title

* 13. What are indications for rib fracture fixation at your institution? Please check all that apply.

Flail Chest

3 or more displaced rib fractures without flail

Inability to control pain with rib fractures

Inability to extubate from ventilator with rib fractures

"Just passing through" - fix rib fractures during operation for a separate indication