Managing children’s forearm fractures in the emergency department

2021 ◽  
Vol 30 (1) ◽  
pp. 18-23
Author(s):  
Jenny Edmonds ◽  
Matilda Bignell ◽  
Phoebe Coward ◽  
Sarah Leonard ◽  
Emma Wolten
Keyword(s):  
Emergency Department ◽  
Forearm Fractures

741 Manipulation and Reduction of Paediatric Forearm Fractures in The Emergency Department Using Intranasal Diamorphine and Entonox

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
S Kapoor ◽  
A Valand ◽  
J Dartnell
Keyword(s):  
Emergency Department ◽  
Patient Discharge ◽  
General Anaesthetic ◽  
Forearm Fractures ◽  
Distal Radial Fractures ◽  
Access To Treatment ◽  
Early Access ◽  
The Mean ◽  
Salter Harris

Abstract Background Paediatric forearm fractures are commonly encountered in Trauma and Orthopaedics. Currently most forearm fractures are manipulated in theatre the following day, increasing resource burden and delays in management. The aim of this project was to introduce guidelines to reduce fractures in the Emergency Department (ED) using intranasal Diamorphine and Entonox. Method 197 cases were identified over a 6-month period in 2018 and 2019. 74 distal radial fractures and 123 mid shaft forearm fractures were analysed. Fractures with an intact periosteal hinge or a Salter Harris type 2 were reduced in ED. The pre manipulation and post manipulation radiographs were compared with particular attention to the post reduction angles. Results 67% of fractures were reduced in the correct setting. A number of fractures reduced in ED required re-manipulation or internal fixation. Overall, there was a 56% reduction in patients undergoing general anaesthetic. There was a reduction in the mean length of stay from 36 hours to 3.5 hours. Conclusions Intranasal Diamorphine and Entonox offer a safe method for managing paediatric forearm fractures in ED. Implementation of this method facilitates early access to treatment and early patient discharge. Manipulation in ED offers significant financial savings and reduces demands on the Trauma Theatres.

The use of esketamine sedation in the Emergency Department for manipulation of paediatric forearm fractures: A 5 year study.

Injury ◽  
2021 ◽  
Author(s):  
Dhawal Patel ◽  
Christopher Talbot ◽  
Weisang Luo ◽  
Shirley Mulvaney ◽  
Eileen Byrne
Keyword(s):  
Emergency Department ◽  
Forearm Fractures

Mini-C-Arm Fluoroscopy for Emergency-Department Reduction of Pediatric Forearm Fractures

2011 ◽  
Vol 93 (15) ◽  
pp. 1442-1447 ◽  
Author(s):  
Mark C Lee ◽  
Norman E Stone ◽  
Andrew W Ritting ◽  
Eric A Silverstein ◽  
Kristan A Pierz ◽  
...  
Keyword(s):  
Emergency Department ◽  
Forearm Fractures

scholarly journals LO065: Reduced length of stay and adverse events using Bier block for forearm fracture reduction in the pediatric emergency department

CJEM ◽  
2016 ◽  
Vol 18 (S1) ◽  
pp. S52-S53
Author(s):  
E. Fauteux-Lamarre ◽  
B. Burstein ◽  
A. Cheng ◽  
A. Bretholz
Keyword(s):  
Emergency Department ◽  
Length Of Stay ◽  
Adverse Events ◽  
Forearm Fracture ◽  
Pediatric Emergency ◽  
Fracture Reduction ◽  
Pediatric Emergency Department ◽  
Forearm Fractures ◽  
Return Visits ◽  
Bier Block

Introduction: Distal forearm fractures are one of the most common injuries presenting to the pediatric emergency department. Procedural sedation (PS) is commonly used to provide analgesia during fracture reduction, but requires a prolonged recovery period and can be associated with adverse respiratory events. Bier block (BB) regional anesthesia is a safe alternative to PS for fracture reduction analgesia. We sought to assess the impact of BB on length of stay (LOS) and adverse events following forearm fracture reduction compared to PS. Methods: We performed a retrospective study of patients aged 6 to 18 years, presenting with forearm fractures requiring closed reduction from June 2012 to March 2014. The primary outcome measure was emergency department LOS; secondary outcomes included reduction success rates, adverse events and unscheduled return visits. Results: Two-hundred and seventy-four patients were included for analysis; 109 treated with BB, 165 underwent PS. Overall, mean LOS was 82 min shorter for patients treated in the BB group (279 min vs. 361 min, p<0.05). Sub-analysis revealed a reduced LOS among patients treated with BB for fractures involving a single bone (286 min vs. 388 min, p<0.001) and both-bones of the forearm (259 min vs. 321 min, p<0.05). Both BB and PS resulted in comparable rates of successful reduction (98.2% vs. 97.6%, p=0.74). There were no major adverse events in either group. Patients who received BB experienced significantly fewer minor adverse events (2.7% vs. 14.5%, p<0.05). Return visit rates were similar in the BB and PS groups (17.6% vs. 17.1%, p<0.05). Conclusion: Compared to PS, forearm fracture reduction performed with BB was associated with a reduced emergency department LOS and fewer adverse events, with no difference in reduction success or return visits.

The utility of clinical ultrasonography in identifying distal forearm fractures in the pediatric emergency department

2019 ◽  
Vol 26 (2) ◽  
pp. 118-122 ◽  
Author(s):  
Iratxe Galletebeitia Laka ◽  
Frederic Samson ◽  
Inigo Gorostiza ◽  
Andrés Gonzalez ◽  
Carlos Gonzalez
Keyword(s):  
Emergency Department ◽  
Pediatric Emergency ◽  
Pediatric Emergency Department ◽  
Distal Forearm ◽  
Forearm Fractures ◽  
Distal Forearm Fractures

scholarly journals Emergency Department Revisits Due to Cast-Related Pain in Children with Forearm Fractures

2020 ◽  
Vol Volume 13 ◽  
pp. 11-16
Author(s):  
Noa Kvatinsky ◽  
Rivka Carmiel ◽  
Ronit Leiba ◽  
Itai Shavit
Keyword(s):  
Emergency Department ◽  
Forearm Fractures
Sign in / Sign up

Export Citation Format

Share Document