Orthopedic and Minor Traumatic Injuries
Orthopedic and Minor Traumatic Injuries
Isolated Orthopedic or Minor Traumatic Injuries (Fractures/Strains/Sprains etc) that DO NOT meet trauma transfer criteria.
Example: Tibial Plateau Fracture, Splinted in Main ED. Placed in CDU for pain control, NV check Q6h
If age > 65 or known osteoporosis, all pelvic fractures (rami, acetabulae etc) must have a CT pelvis with contrast.
Orthopedics consulted by main ED
Need for pain control or rehab consultation, assistive devices, braces etc prior to discharge
MOST LIKELY disposition is home based on ED Provider clinical judgement
Nearly Certain disposition is SNF or Care Facility Placement based on ED Provider Judgement (If home is a possibility after pain control and PT eval, then ok for CDU)
Patient meets criteria for Trauma center transfer
Further imaging planned to rule out undiagnosed traumatic injuries. (a plan to get CT of a known injury for surgical planning is ok, but not one to look for undiagnosed injuries)
Altered mental status
Abnormal Vital Signs
Need for Inaptient Surgery (Hip Fracture, Open Fracture etc)
Weight bearing Status clearly defined
Neurovascular Checks as warranted
Medication
Pain
Scheduled Acetaminophen
Scheduled Ketorlac/Ibuprofen
Breakthrough Oxycodone 5 mg 1-2 tabs Q4 h PRN
Ice Pack
Elevate effected extremity
PT Eval and Treat Order (as needed)
Fall Precautions (as needed)
Disposition
Pain controlled
No further concern for compartment syndrome or other complication
Outpatient follow-up plan defined
Assistive devices available
Able to complete ADLs with Family and Home health Support
Uncontrolled Pain
Patient requires SNF based on PT eval
Unstable Vitals signs, change in mental status
Further undiagnosed injuries discovered or suspected (likely needs trauma transfer)
Learning Links: