MDCalc

Sequential Clinical Assessment of Respiratory Function (SCARF) Score

Predicts adverse outcomes in critically ill rib fracture patients.

Use to assess management of pain in patients with acute traumatic rib fractures. If patients’ SCARF score remains >2 then increasing level of analgesia should be considered.

Incentive spirometry <50% of predicted

Respiratory rate >20 breaths/min

Numeric pain score ≥5

Cough inadequate to clear respiratory secretions

Result:

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Advice

If patients’ SCARF score remains >2 after initial intervention, then consider increasing level of analgesia.

Management
  • Level 1 - opioid alternatives, topical anesthetics, oral opioids, low dose IV opioids.
  • Level 2 - nerve blocks, pain pumps, erector spinae catheters.
  • Level 3 - opioid PCA, lidocaine/ketamine infusions.
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