Assessing a fractured leg in the Accident and Emergency (A&E) department involves a systematic approach to evaluate the extent of the injury and provide appropriate care. Remember, the assessment should always be conducted in a gentle and compassionate manner, taking into consideration the patient’s comfort and well-being throughout the process.
Here’s a step-by-step guide on how to medically assess a fractured leg in A&E
1. Primary Assessment: Begin with a primary assessment to identify any life-threatening conditions or injuries. Assess the patency of the patient’s airway, breathing, and circulation (ABCs). If there are any immediate life-threatening issues, address them first.
2. History Taking: Obtain a brief history from the patient or any available bystanders. Ask about the mechanism of injury, any pre-existing medical conditions, allergies, medications, and recent events leading up to the injury.
3. Observation: Carefully observe the patient’s leg for any obvious signs of injury, such as deformities, swelling, bruising, open wounds, or bleeding.
4. Palpation: Gently palpate the leg to assess for tenderness, crepitus (a grating sensation), and any bony or soft tissue abnormalities. Start with the uninjured leg to establish a baseline for comparison.
5. Neurovascular Examination: Perform a neurovascular assessment to check for any neurological and circulatory deficits. Assess sensation, pulses, and capillary refill in the affected limb.
6. Range of Motion: Assess the range of motion at the hip, knee, and ankle joints. Note any restrictions, pain, or abnormal movement.
7. X-rays: Request X-rays of the affected leg to confirm the presence and location of the fracture. X-rays help determine the type of fracture, its severity, and any potential associated injuries.
8. Secondary Survey: Once you’ve completed the initial assessment, conduct a secondary survey to look for other injuries that may have been missed during the primary assessment.
9. Pain Management: Administer pain relief as appropriate. This could be in the form of analgesics or other pain management techniques.
10. Immobilization: Depending on the type and location of the fracture, immobilize the leg using splints, braces, or casts to prevent further injury and provide comfort.
11. Elevation: Elevate the leg to help reduce swelling and alleviate pain.
12. Documentation: Accurately document the findings of your assessment, the treatment provided, and the patient’s response to pain relief measures.
13. Consultation/Referral: If the fracture is severe, complex, or requires specialized care, consult an orthopaedic surgeon or transfer the patient to a higher-level facility for further evaluation and management.
Great 👍🏾
Thank you Dr