Fracture

Question 1

What might you ask on Hx for a fracture?

Answer 1

- Hx of injury
	○ Where
	○ When
	○ How
	○ Accident/not
	○ Head involvement if a fall - LOC + associated red flags of head trauma

• Other Hx
  ○ Previous #
  ○ FHx/PMHx coagulopathies
  ○ Accidental/non-accidental

Question 2

What might you examine for a fracture?

Answer 2

General - e.g. unwell/well, WOB
○ Inspection: swelling, deformity, open?
○ Vascular: warm? Pulses? Cap refill? 
○ Sensation
○ ROM
○ Other injuries

Question 3

What might you use to assess pain?

Answer 3

• face, faces scale, movement, tense, vitals, consolable or not

Question 4

Initial Ix for a fracture

Answer 4

• Lateral and AP view

- Joint above and below

Question 5

What are some different ways you can manage pain for a fracture/drips?

Answer 5

• Panadol
  
  • Opioid
  • green whistle - Fentanyl
  • immobilisation - sling/backslab
  • Distraction
  • Emla/angel cream for drips etc
  • Sucrose for baby
  • midaz for drips

Question 6

What are some things you should advise families on re: plaster care?

Answer 6

1. Elevate: if arm, keep above heart lvl as much as possible
2. Swelling: encourage wiggling, not too tight
3. Skin care: don’t put anything b/n cast and skin, check skin daily
4. Case care: clean, dry, avoid bumping, don’t paint case (closes pores)