Patient had terrible fall

[neuron]

So my patient had a terrible fall last week. She ended up with a broken wrist. I go in today and notice HUGE bruises (with what appears to be hematomas on her back). She has already been to the doctor as they have record of her fall. I am not sure and am not confident that they know about this.

How do you treat bruises like this?

[K+MgSO4, BSN]

Report it and get xrays if there are suspected rib fractures. Bruising to the torso may be due to soft tissue damage up to internal bleeding. This is about patient care.

If all NAD analgesics and deep breathing and coughing exercises for chest physio to prevent actelectsis. Keep stools soft to prevent straining. Not much that can be done for the actual bruises visually.

[JKL33]

You must notify the provider responsible for the patient. Together you can decide if additional investigations are necessary and how to provide supportive care related to them.

[neuron]

What I did was apply warm compresses to the bruises. She will see her provider tomorrow.

[Green Tea, RN]

Does your facility have a policy for patient's fall?

[neuron]

This was an in home visit. All good answers, but she is on anti-platelet and anti-coagulant medication, x ray would be appropriate but wouldn't there be a concern for blood clotting d/t hematoma

[twinmommy+2, ADN, BSN, MSN]

This was an in home visit. All good answers, but she is on anti-platelet and anti-coagulant medication, x ray would be appropriate but wouldn't there be a concern for blood clotting d/t hematoma

Technically the hematoma is a blood clot/blood pooling in the area of the injury. The subcutaneous hematoma is not the problem unless its so large that it presses on other structures, say if it was a retro peritoneal bleed. Cold compresses for 24-48 hours post injury would help with assist with clotting. If the injury is in the kidney area, I would also want a urine checked and check her H&H, PTT, PT INR