Quote from meownsmile
I'm surprised they didnt give her a dose of vit K right off if they found her prox's to high on admission. 3-4 days is a long time for a patient to have to wait for repair or replacement after a fracture. They like to go as soon as possible to avoid the swelling and bruising that comes after 24 hours. Glad they got it done but that is still a long time for a patient to have to wait. Werent they having horrible muscle spasms? The traction helps decrease the muscle spasms associated with the fracture.
I was not on same unit with pt - on a telemetry unit; just knew student, who was tech on our unit. Anyway....apparently docs gave first dose Vit k (5 mg)
~ 40 hrs p admission, then another dose (10 ng) 24 hrs p that. Pro x's/INR were 27.0/2.6 on admit; 32.6/3.1 next day; 34.3/3.2 at 38 hrs;
27.9/2.6 p 1st dose Vit K; 17.4/1.6 p 2nd dose - students take great notes about labs
.......Dilaudid 1mg then 2 mg q3h for pain (but student could not remember any comments about muscle spasms, only external rotation as cause....
Pt ended up with big sacral decub 4 days p admit - found in OR - so your point is well taken about value of Vit K earlier --> OR earlier. And post op care (in surg ICU bcse of cardiac hx) which included frequent T&P to pt's benefit