double elle said:
Hi all -
I need to come across a....
If you have the means to do so, take a couple nights call with an ortho resident. In exchange for your help (that will certainly be much appreciated) you will likely get a good dose of instruction on how to describe fractures (ie over the phone) as well as how to apply splints. In all reality, these two skills are what you really will be lacking and which you most need to have while moonlighting. The average resident with a PACS nearby can show you a variety of fractures (hips, wrists, ankles) and help you learn to describe what's going on.
If you can do the following you will be leaps and bounds ahead of the average moonlighter who calls a trauma center:
O) Decribe the mechanism
A) name the bone(s) involved
B) describe the fracture type (e.g. open/closed, displaced/non-displaced, comminuted/non-comminuted, intra-articular/non intra-articular, transverse/oblique/spiral)
C) Describe VASCULAR STATUS (i.e. intact, equal to uninjured side)
D) Describe SENSORY NEUROLOGIC STATUS of the affected limb (e.g. 2-point intact, parasthesia)
E) Describe MOTOR NEUROLOGIC STATUS of the affected limb (5/5, 4/5, etc)
F) Decribe range of motion (e.g. intact full active (Pt can do alone) range of motion, ROM limited by pain, no active ROM)
G) Decribe tender/non-tender to palpation
H) Characterize compartments hard/soft
Hand injuries, well, just send the patient on with $75 (that you "earned" that hour) for the local ortho resident who will accept your headache/nightmare.
If all else fails, when calling an accepting orthopod, ask "what should I do to make sure that the patient is stabilized overnight/for transport." Any reasonable orthopod (i.e. most) would be happy to help direct a referring physician who is eager to help the patient.