The PIC (Pain, Inspiration, Cough) score can be used in patients with multiple rib fractures. The score was originally developed by Wellspan York Hospital in York Pennsylvania.
Patient selection: chest trauma with multiple rib fractures
Parameters:
(1) pain as indicated on a 10-cm VAS scale
(2) inspiration on inspiratory spirometer, versus goal and alert levels set by the respiratory therapist
(3) cough
Parameter
Finding
Points
pain
controlled (VAS 0-4)
3
moderate (VAS >4 and <8)
2
severe (VAS 8 to 10)
1
inspiration
above goal volume
4
within goal range and above alert volume
3
below alert volume
2
unable to perform
1
cough
strong
3
weak
2
absent
1
total score =
= SUM(points for all 3 parameters)
Interpretation:
• minimum score: 3
• maximum score: 10
• The higher the score the better the patient's condition.
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