Missed one - page 4

I am still new but I feel like I'm pretty good at screening out my fakers. I've had a little boy be sent to me every day this week for a sore foot. He was playing around at home and fell down the... Read More

  1. by   WineRN
    Quote from OldDude
    NO - something still ins't right. You'll never have "no restrictions" for a Salter II. That's a fracture across the growth plate and involving the metaphysis too. Usually gets casted after a few days to allow for swelling reduction, NWB.
    I called as soon as I looked up what the fracture was, no call back from office.

    Both of the parents work in the hospital where the child was seen (non medical roles), so I do agree there is something fishy about all of this
  2. by   djh123
    Jumping rope w/no s/s pain and 'multiple broken bones' in a foot. Uh-huh...
  3. by   GrumpyRN
    Quote from OldDude
    NO - something still ins't right. You'll never have "no restrictions" for a Salter II. That's a fracture across the growth plate and involving the metaphysis too. Usually gets casted after a few days to allow for swelling reduction, NWB.
    Sorry OldDude, I am going to disagree with you. I would put in moonboot with ortho follow up. No crutches and weightbear as able. Definitely would not be casting.

    I was reading this and calling BS on the "multiple fractures" in the foot while no swelling/bruising and fully weightbearing.
    If the child attended me as an ENP I doubt I would even have x-rayed. I would have sent home with advice.
  4. by   OldDude
    Quote from GrumpyRN
    Sorry OldDude, I am going to disagree with you. I would put in moonboot with ortho follow up. No crutches and weightbear as able. Definitely would not be casting.

    I was reading this and calling BS on the "multiple fractures" in the foot while no swelling/bruising and fully weightbearing.
    If the child attended me as an ENP I doubt I would even have x-rayed. I would have sent home with advice.
    Since I consider you my UK brother from another mother I think it's healthy for us to have different opinions about some stuff. Disagree, argue, agree to disagree and go have a few pints.
  5. by   GrumpyRN
    Quote from OldDude
    Since I consider you my UK brother from another mother I think it's healthy for us to have different opinions about some stuff. Disagree, argue, agree to disagree and go have a few pints.
    Sir, you are a gentleman.

    You have taken my comment in the spirit it was intended - professional disagreement in management.


    The culture in UK would allow me to miss a fracture as long as I had documented my examination completely and my decision making process was clear. Yes, even without x-ray.

    In fact in the past I have missed a fracture and a complaint was made and because I could show why I missed it and why I did not x-ray, and medical staff agreed (they had helped to train me), nothing came of it.

    Strangely, I was going to go for a few pints tonight but quite literally as I came up to the computer to reply to you I decided to stay at home.

    Have a good weekend.
    Last edit by GrumpyRN on Jan 12 : Reason: Adding quote
  6. by   WineRN
    Quote from GrumpyRN
    Sorry OldDude, I am going to disagree with you. I would put in moonboot with ortho follow up. No crutches and weightbear as able. Definitely would not be casting.

    I was reading this and calling BS on the "multiple fractures" in the foot while no swelling/bruising and fully weightbearing.
    If the child attended me as an ENP I doubt I would even have x-rayed. I would have sent home with advice.
    The doctor is on the same train of thought as you. Because the little one isn't exhibiting any signs of pain and has been able to bear weight since the initial injury, they only want her in the boot.

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