Comments on: Hip Fractures

By: Auto Angel

Auto Angel — Mon, 28 Sep 2009 10:04:21 +0000

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By: Anonymous

Anonymous — Wed, 10 Dec 2008 13:22:00 +0000

Do you medicate a person with a lower leg fracture before you splint the extremity? BLS befoe ALS. Most if not all of these elderly pt have no natural padding. Stay away from the scoops and hard backboards. Immobilize these patients on a full body vacuum mattress in a position of comfort and then reevaluate for pain management. Most of the time they will not need it. Follow some of these patients through the system and find out how many ended up with pressure sores after laying on a scoop or backboard for 2 and 3 hours. Sitting on your stretcher with the effected leg slightly bent will make your customer much happier.

By: Witness

Witness — Sat, 22 Nov 2008 13:00:00 +0000

I just looked it up in my EMD cards, and right there – “Ground-level falls in elderly patients commonly result in hip fractures, which are not prehospital emergencies.”Seriously? That’s insane.

By: Life Of An Emt

Life Of An Emt — Fri, 21 Nov 2008 06:10:00 +0000

wow you have really made me re-think the possible hip fx calls I have to go on as a basic truck. Where we live we are strapped for medic’s we do priority 1 to the call. which I am glad that you did this post. I recently had to take a trauma pt on a long haul no I.V of course because I am a bls unit. but they did have him hep locked alot of good that does me. but anyway I had a 42 y.o.m involved in MVI he was intoxicated at the time of the accident. it wasn’t my call so I didn’t not get to see the vehicle nor the damage but after getting him to the er where he was examined their findings was that he broke his Acetabulum. which I never heard of until this call and really had no idea until you did this post of the seriousness of this type of fx. the pt had been in the er for over 6 hrs. before i get the call to tp to lsu – shreveport. the tp time is appox 1 hr 45 min give or take depending on traffic now that is almost a total of 8 hrs since this person last possible drink. they did not give him any pain medication because of his alcohol levels when he first got there. nor did they give him any before the trip is there a rational explanation for them doing this that i do not know of? i would of thought with the amount of time that had passed he would of been able to recieve something for pain but I would of atleast thought they would of ran an IV. the initial report that was given to the recieveing facility was IV fluids. Not a hep lock that the pt pulled out. That was a lovely call all the way around. Not only did I have to listen to the poor pt screaming in pain, but I also had to take a chewing for him pulling it out and not being able to put one back in. also the c-collar and spine board was removed from the pt in the hospital so the cheek that wasn’t chewed on initially got gnawed on too.

By: PC

PC — Thu, 20 Nov 2008 02:17:00 +0000

Thanks for all the comments. I plan to investigate this whole issue more. I thing an issue like this causes us to look at ourselves in the mirror and ask what is EMS about? Is it about being available for the big one or is about taking care of our frailest citizens when they are in excruciating pain? Ideally EMS should be both things. I would really like to see some breakthroughs in pain management that would enable basics to be able to provide better pain control. I don't know that much about the nitrious oxide to say, but I think this whole area of pain management and prehospital priorites needs to be explored more.Thanks again for all the comments and look for a new column in a few weeks hopefully adding some more thoughts on this whole issue.Peter C