Single Shot Serratus Anterior Block for Rib Fractures in the Emergency Department (SABRE)

Campbelltown Hospital will be part of a randomised multi-centre study investigating whether a single shot serratus anterior plane block (SAPB) in addition to our protocolised rib fracture pathway reduces pain scores and associated complications in adult patients with clinical or radiologically confirmed rib fractures presenting to the emergency department.

Primary Outcomes: Compare pain scores between study group (standard of care + SAPB) and control group (standard of care only).

Secondary Outcomes: Compare rates of pneumonia, incidence of delirium, total opiate administration over 24-hrs, rate of rescue blocks, LAST frequency, pneumothorax rate, need for and duration of NIV/MV, ICU and hospital LOS, 30-day mortality and QOL at 30-days between the two groups.

Inclusion Criteria:
*All patients > 16 years old with,
*Clinical or radiologically proven rib fractures and,
*An ongoing analgesic requirement after receiving parenteral opiates.

Exclusion Criteria:
*Intubated patients
*Prehospital SAPB
*Patients transferred for urgent surgical intervention
*Moderate-severe traumatic brain injury (GCS≤13)
*Major concomitant injury identified on imaging i.e., Femoral / Spinal fracture, Intra-abdominal visceral injury ± free fluid.

More information can be found in the study protocol.

Study Flowsheet

Training for Study

In order to participate in the SABRE study, eligible clinicians will be required to complete a SAPB competency process. This is outlined under credentialing - Regional Anaesthesia and online training module.

Brief Overview of the Serratus Plane Block

Patient Information & Consent Forms

Randomisation Process

Preparation Guide

SABRE Block Packs can be found in the box next to the blue SABRE folder in Resus. The only extra things you need to grab are gloves and the US.

Reminders of how to prepare the local anaesthetic and equipment required can be found in the blue SABRE folder and on the US machine.

Data Form

Doctor & Nurse to complete forms and return completed forms to folder located in resus. Reminders of how to prepare the local anaesthetic and equipment required can be found on the US machine.