‘Fracture’ is defined as discontinuity in the bone surface. Immediate Nursing management of a patient with fracture can save the life and help to obtain optimum recovery.
when a patient comes to the casualty/ER with fracture following symptoms are usually seen.
- swelling or bruising over bone
- deformity of the limb (shortening in the length of the affected limb)
- worsening pain when moving or applying pressure over the affected area.
- an inability to bear weight by affected foot, ankle, leg.
- loss of function in the injured area.
- in open fracture, the bones will be protruding from skin.
Immediate Role of Nurse in Fracture
- Check (ABC) Airway, Breathing, Circulation.
- Immobilization: This is very much vital to prevent further damage to the blood vessels, nerves, and the soft tissue by the broken pieces bone. It is better to immobilize the joints distal and proximal to site of fracture to minimize the movement. immobilization may be attained by splints.
- An open fracture should be covered with sterile dressing & for immobilization splint should be applied. Reduction is contra-indicated in view of blood vessel & tissue damage.
- Assess Neuro Vascular status before and after splinting. check pulse and sensation distal to the fracture.
- Administer Tetanus Toxoid (inj.TT) vaccine, Analgesics & Antibiotics according the doctor’s order.
- Ensure adequate Fluid is replaced to meet the internal and external hemorrhage.
- Prepare the patient for X-ray. Be cautious to not to move the affected part during shifting.
- Discuss with the doctor regarding further plan of management. i.e surgery, closed reduction etc. if surgery is emergency, keep the patient on NPO, and get Written consent, do skin preparation, site marking etc.
- Reassure the family & explain the management of fractures.