Transcript Pediatric Factures

Pediatric Factures
Jan Bazner-Chandler
RN, MSN, CNS, CPNP
Fractures
Treatment determined
by type of fracture
Fractures
Comminuted fracture
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Salter Fracture Classification
Salter-Harris Classification
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If injury involves growth plate in an immature bone,
growth disturbance may follow.
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Classification system describes the injury and the
potential for growth disturbance.
Traction
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Used to stabilize the fracture site until a cast or surgery
Principles of Traction
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Counter traction with weights.
Make sure all ropes and pulleys are aligned and weights
are hanging freely.
Do not remove weights unless instructed to do so – you
do not want to displace the fracture.
Traction must be applied at all times.
Physician order should include amount of weight to be
applied.
Bryant’s Traction
Bryant’s Traction
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Used for child under 3 years
Hip dysplasia / fractured femur
Buttocks do not rest on mattress
Assess neurovascular and restriction by ace bandages –
compartment syndrome.
External Fixation
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Pin Care
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Provide pin care as ordered.
Cleanse area around pin with normal saline or halfstrength hydrogen peroxide.
Have parent / caretaker demonstrate pin care before
discharge.
External Fixator
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Plates and Pins
Plates, screws, and
wires are used to align
bone fragments.
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Post-operative Care
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Assess color, sensation, cap refill, movement, pain, and
pulses.
Circle any drainage noted on cast or dressing.
Pain control
Edema = ice to area
Pulmonary function = C&DB
Pulmonary Embolism
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A complication of a fracture especially of the long bones.
Fat escapes the marrow when the bone is fractured and
can travel through the blood stream and become lodged
in small vessels like the arterioles and capillaries of the
lung.
Primary symptom is shortness of breath and chest pain.
Interventions
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Place patient in high fowlers
Administer oxygen
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Chest x-ray
Outcomes are better for a healthy person; poorer for
person with pre-existing lung problems.