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Discussion

Pinned leg

Okay, so I'm not really sure where to post this, but I have a question.

Earlier today my boyfriend and I came home and it was a nice day, so we opened all the windows. A few minutes after, we heard yelling from somewhere. It turned out one of our neighbors across the street was moving some large chunks of wood in a smaller, open trailer type thing (real descriptive I know). My boyfriend says they were railroad ties.

Anyway, we went outside on the porch to find out where the yelling was, saw some other neighbors running over there and my boyfriend took off before I could get my shoes on. I wasn't sure what was going on at that point so I hadn't rushed over there with him, until he started yelling for me.

So I went over there and the guy already had his leg out and was stumbling around in pain. When I got there my boyfriend told me he "hurt his leg pretty bad." My boyfriend told everyone I was a nurse (which I don't really like d/t liability issues and whatnot, and I'm really just paranoid). Anyway, the guy had an indentation in the back of his calf, and a smaller one in the front. It was red, and I'd guess the indentation ridge to ridge was maybe half an inch at most, definitely not as deep, and a bit red as to be expected.

We were all telling him to go to the doctor, another neighbor mentioned an ambulance, mentioned checking up on him later as he lives alone. We all told him to quit working for the day and go inside to elevate and ice his leg.

My question is, is there anything else I could have or should have done? It made me realize how little we learn in nursing school about these sorts of situations, and emergencies (I'm finishing up my ADN program). I couldn't really think of anything else to do or tell him. Really, there wasn't much else to do in terms of first aid - no cuts or anything, he was able to put weight on his leg (it hurt at first of course but seemed to get better, we stayed for about 10 minutes after his leg was freed). It didn't seem broken or anything. He mentioned the muscle hurting when he walked, specifically.

Honestly it really seems like he's going to be fine. We all put an emphasis on going to the doctor if it doesn't feel any better at all within a day or two. I'm really just paranoid about doing something wrong or not doing something I should have in situations like this (or worse situations).

Any advice is appreciated!

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    First...I don't mean to be harsh but your boyfriend cannot call you a nurse. You are not one...unless you are an LPN. Many states have laws that protect the title NURSE and it is punishable by law. Title "Nurse" Protection: Summary of Language by State

    If you work where your profile says they have a law...

    The board may license a natural person to practice as a registered nurse or as a licensed practical nurse. However, only a person currently licensed as a registered nurse in this state may use that title and the abbreviation “RN” after the person’s name and only a person currently licensed as a licensed practical nurse in this state may use that title and the abbreviation “LPN” after the person’s name. For purposes of this section, “currently licensed” includes persons licensed in another state and recognized for licensure in this state pursuant to the nurse licensure compact or pursuant to the advanced practice registered nurse compact
    .http://www.ena.org/government/State/Pages/Iowa.aspx

    Now as a student nurse/nurse your ability to help is limited. This is where I remind ALL NURSES to carry malpractice insurance.

    The best you can do is encourage them to seek help (call 911) and to sit down. If there was profuse bleeding apply pressure and call 911. They were walking but that still doesn't mean it isn't broken. However this is a crush injury....Swelling later can cause a limb threatening condition called compartment syndrome. Offer again to call 911. Even telling someone to ice their leg is medical advice and should be followed with...do not apply ice directly to the skin and NO LONGER than 20 mins every hour as it may cause burns and you need to seek treatment and call your PCP TODAY!

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    I would have called 911. Let him refuse to EMS & have it documented. You were out of scope to do anything more than a layperson as it seems you don't have a basic first aid cert ( most nurses don't).

    If it were me first Id say "thanks honey I am NOT a nurse but a student how can I help?"

    Then let's call 911 as I don't have ultrasound fingers or X-ray vision to see if there is any muscle, tissue or nerve damage. Sit still until the EMS team arrives. " (in other words we cannot see injury extent in the field lets leave the diagnosing to the MD, DO, APN etc). This also worked when I was an EMT and patients would ask if I thought their leg was broken.

    If this was a crush injury waiting a day or two can be devastating. Always recommend 911, ER or call MD now.

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    Call 911 and get him to stop walking on it

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    • Author

    I realize I forgot to mention that I am actually an LPN. He told them I'm a nurse, later (less than 10 minutes later) mentioned I was finishing my RN.

    I did say not to ice longer than 20 minutes. My boyfriend and I tried to go to his house about 2.5 hours later but he wasn't home. I might stop by later today and see how he's doing.

    Thanks everyone.

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    Be careful in following up since your boyfriend announced that you are a nurse continued follow up may be construed as a nurse-patient relationship and if he has a serious crush injury....."well neighbor nurse told me just to ice it and see my doc in a few days. She didn't tell me to go to the ER". Most nurses are not first responders and don't have the training & equipment to do much more than call 911, hold pressure on active bleeding or initiate CPR.

    If it were me I wouldn't keep checking up, perhaps say hope you are feeling better if you see him in passing but not much more

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    • Author

    Well we all had urged him immediately to go to the ER or doctor. The only reason ice came up from any of us (there were 5 of us not including this man) is because he kept refusing to go. Several of us said we'd check in on him.

    Anyway, he did end up seeing a doctor last night.

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    Ugh...... compartment syndrome scares me. I saw the results of it in clinical one day..... He should go to the ER today.

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    • Author
    Ugh...... compartment syndrome scares me. I saw the results of it in clinical one day..... He should go to the ER today.

    Read my last post ;)

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