Trauma Week Day 1 Tib/Fib Fracture

Fractures can be simple or complex, but the team that is required to create a healing environment is vast. Over the next week we will look at how many different modalities and professionals that are needed to take care of one patient. Today we focused on the trauma and ER. What happens after injury? Once the patient has been picked up by the ambulance the EMTs report to the nearest hospital, stabilize the patient, take the patient for radiography testing, and come up with a definitive treatment plan. Mobile Fire and Rescue call in to the ED and give a short summary of the patient. 17 y/o male. Open left Tib/Fib fracture, s/p impact with player on football field. NEG LOC. +PMS intact. Immobilized/bleeding controlled prior to transport. VSS. AAO x3. When preparing for the patient the hospital team must gather the necessary equipment and teams. The teams includes nurses, ER/trauma, doctors, orthopedic doctors, radiology, etc... The equipment includes IV supplies, medications, traction, monitoring, blood products, etc... What should you do with this injury? Monitor vital signs, pain control, package for radiology, PMS (pulse, motor, sensory), assess for pulses distal of the injury. We will be assessing for the Posterior Tibial and Dorsal Pedis by palpatation or with the doppler. Motor (wiggle your toes for me). Sensory (can you feel me touching you). Splint in place for radiology and apply hare traction. Traction's main goals are to control pain from muscle spasms. Reduce fractures maintaining anatomical reduction, and to prevent and correct deformity. Other types of traction are skeletal and skin traction. If we are looking for the specifics to snap a piece of a skeleton, it takes about 4,000 newtons of force to break the typical human femur. A lot depends on the bone itself, its position in the body, and the angle of the attack. The age, diet, and lifestyle of the bone-owner also plays a role. It's hard to articulate all the resources, skills, knowledge, and compassion that is needed to care for these types of injuries that occur everyday. As we go throughout the rest of Trauma Week we will try to keep count of how many people touch each one of these patients lives.