As we age, our bones become more brittle and easier to fracture. This, coupled with the fact that elderly patients are more prone to falls, indicates hip fractures are common in the elderly age group. Each year, 1 in 3 adults over the age of 65 will fall. A hip fracture can occur from a simple fall to the ground and great caution is needed to provide care and prevent further injury. Hip fractures are considered one of the most painful fractures.
To provide help to this patient, place pillows under and around the hip. This will not only pad the area from the hard ground but will also aid in splinting. When a hip fracture is suspected, prevent the patient from moving. Less movement will minimize pain and prevent further injury and bleeding. Some key signs and symptoms of a hip fracture include mechanism of injury, extreme pain, deformity and outward rotation of the foot.
SPINAL INJURIES
The bones of the spinal column are called the vertebrae and are the main supporting structure of the skeletal system. In addition, it houses the spinal cord. Because of these critical functions, it is important to spend some extra time when caring for suspected or likely spine injuries.
Spinal injuries most commonly occur from trauma. Pain, with or without movement, is the classic symptom associated with spinal injuries. Complaints of numbness, weakness, tingling or the inability to move limbs may indicate spinal cord injury as well. In severe cases, a patient may lose bladder or bowel control and may have difficulty breathing.
Keep in mind, the absence of pain does not, in any way, rule out the possibility of a spinal injury. This is especially true when alcohol or drugs are involved as either can mask the pain. Notify your PIC and call Aircare Access if spinal injury is suspected.
While doing your primary survey, have a bystander stabilize the patient’s head and neck in a neutral position. This position should be maintained until professional medical help arrives. Do not use traction for a suspected spinal injury.
When assessing someone for a possible spinal injury, key questions include:
• What happened? • Does your neck or back hurt? • Do you hurt anywhere else? • Can you wiggle your fingers and toes?
For unresponsive trauma patients, stabilize the head and neck in the position you found the patient. Only move a trauma patient if you are unable to assess breathing, if the patient is not breathing or if safety is in question. To stabilize the patient’s head and neck, place one hand on either side of the head. Spread your fingers wide and support the lower part of the ear and the neck at the same time. You are simply there to remind the patient not to move. Someone should stay in this position until professional medical personnel can apply a cervical collar.
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